Comparison of hemodynamic response to tracheal intubation with laryngoscope versus intubating laryngeal mask airway in elderly hypertensive patients

Abstract

Background Management of airways during intubation is a very stressful process that affects the hemodynamics, especially in elderly hypertensive patients. We aimed in this study to compare the hemodynamic response to tracheal intubation in elderly hypertensive patients using ILMA and Direct laryngoscopy. We aim in this study to prove that hemodynamic consequences with intubation using ILMA is that intubation with an ILMA has less hemodynamic consequences that last for a shorter period compared with DL in elderly hypertensive. Patients and methods A total of 70 patients of both sexes, ASA physical status II, above 60 years of age, undergoing elective abdominal surgery lasting less than 2 h were divided randomly using a regular sample method into two equal groups. Intubation was performed using a Macintosh laryngoscope in group (direct laryngoscopy), and in the second group [intubating laryngeal mask airway (ILMA)] intubation was performed with laryngeal mask airway. Hemodynamic data and oxygen saturation were recorded. Intraoperative adverse effects and postoperative complications such as sore throat, hoarseness of voice (during the first 24 h after surgery), and laryngospasm were recorded. Results There was a significant increase in heart rate and mean arterial blood pressure immediately after laryngoscopy and tracheal intubation until 3 min when compared with ILMA. Moreover, there was significant increase in heart rate, mean arterial blood pressure, and rate pressure product after tracheal extubation for 3 min, whereas it was for 1 min in the ILMA group. No significant difference was seen between the number of patients with or without symptoms after extubation in both groups. Conclusion Intubation with ILMA has less hemodynamic consequences for a shorter time compared with direct laryngoscopy in elderly hypertensive patients.