Comparison of fastrach LMA and ILMA methods for airway management

Mustafa Ozgur Cırık,Ramazan Baldemir,Sema Avcı,Hayal Tezel,Mustafa Tayfun Aldemir

doi:10.33582/2639-4391/1006

Abstract

The aim of this study is to compare the hemodynamic responses, durations of intubation, intubation success rates and postoperative upper airway complications between the intubation performed with direct laryngoscopy and blind intubation performed with LMA-Fastrach application in normotensive patients. This present study was performed with the approval of ethical committee and in the surgery rooms between the date March 2010-August 2010. The study was performed on 80 patients aged between 18 and 60 and had American Anesthetists Assosiation (ASA) classification I-II. Endotracheal intubation was essential in their elective abdomen surgeries. The patients were divided into 2 groups as ILMA-Fastrach Group (Group I, n=40) and laryngoscopy group (Group L, n=40). 80 patients aged between 18 and 60. Of those, 54 (67.5%) were female and 26 (32.5%) were male. The age average of the patients was 46.3 ± 10.7. There was not a statistically significant difference between the demographic parameters of the patients. When compared to the onset value of SAP in Group I and Group L, a statistically significant difference was not detected in the groups in terms of SAP 1st minute and 5th minute values. When compared to the SAP onset value of the cases, the decrease in the 1st minute was statistically significant and when compared to the 1st minute value, the decrease in the 5th minute was not statistically significant. In the groups, a statistically significant difference was not observed in terms of DAP outset 1st and 5th minute values. When compared to the DAP onset value of the patients in Group L, the increase in the 1st minute was statistically significant. When compared to the 1st minute value, the decrease in the 5th minute was statistically significant. When compared to the onset value of MAP in Group L, the increase in the 1st minute was statistically significant. In terms of HR onset 1st and 5th minute values a statistically significant value was not detected. In conclusion, patients performed endotracheal intubation with LMA-Fastrach was more stabile than the ones intubated with direct laryngoscopy in terms of hemodynamics. Fewer complications were observed in LMA-Fastrach group and there was not any difference in terms of success rates.

Highlights

Endotracheal intubation performed during general anesthesia provides many advantages such as maintenance of airway patency and safety, respiratory control, less effort for respiration, less dead space and decreased aspiration risks [1,2]
The aim of this study is to compare the hemodynamic responses, durations of intubation, intubation success rates and postoperative upper airway complications between the intubation performed with direct laryngoscopy and blind intubation performed with laryngeal masks (LMA)-Fastrach application in normotensive patients
Laryngoscopy and endotracheal intubation develop a sympathetic reflex response based on the mechanical stimulation of the larynx and trachea; this sympathetic response may cause increase in plasma catechalemine levels, tachycardia, hypertension, arthymia and myocardial ischemia especially in patients with limited heart reserve [3]

Summary

Introduction

Endotracheal intubation performed during general anesthesia provides many advantages such as maintenance of airway patency and safety, respiratory control, less effort for respiration, less dead space and decreased aspiration risks [1,2]. Laryngoscopy and endotracheal intubation develop a sympathetic reflex response based on the mechanical stimulation of the larynx and trachea; this sympathetic response may cause increase in plasma catechalemine levels, tachycardia, hypertension, arthymia and myocardial ischemia especially in patients with limited heart reserve [3]. The application of layrngeal mask does not stimulate layrngeal reflexes as much as laryngoscopy does, and its cardiovascular response is more restricted when compared with laryngoscopy [5]. Many laryngeal masks (LMA) are being used for airway safety, Fastrach LMA or intubation LMA (ILMA) has been specially designed for easing endotracheal intubation and maintains the ventilation [6]. The primary advantage of ILMA designed by Dr A.I.J. in 1997 is that it does not necessitate head and neck manipulation during the application and the practitioner does not need to place their finger into the patient’s mouth [7,8]

Objectives

Methods

Conclusion