Abstract
Background The airway of an anesthetized child is usually maintained with an endotracheal tube or laryngeal mask airway. However, both are related with some level of pressor response which may be risky in several groups of patient. Methods An institutional-based prospective observational study design was employed. A systematic random sampling technique was used to select study participants. Data were entered into Epi info version 7 and transported to SPSS version 20 for analysis. Normality of the data was checked using Shapiro–Wilk tests. An independent t test was used to determine the mean differences between the two groups while the paired sample t test was used to determine the mean differences within the groups. A p value of less than 0.05 was used as a cut-off point for the presence of association. Results The changes in systolic and diastolic blood pressure were returned to baseline values at five and three minutes in both groups, respectively. However, the changes in the heart rate and mean arterial pressure returned to baseline values in five minutes in the ETT group and three minutes in the LMA group. At baseline, the difference in systolic blood pressure between the two groups was not statistically significant (p=0.328). Conclusions A significant hemodynamic pressor response was observed after the insertion of both LMA and ETT groups. However, the LMA group has less hemodynamic change as compared to the ETT group. Therefore, the practice of LMA insertion was strongly recommended.
Highlights
Laryngeal mask airway (LMA) and endotracheal tube (ETT) intubation are among the most important artificial airway devices used at the time of general anesthesia [1]
Continuous outcomes formula was used to calculate the sample size based on a previous study done in India [15], which showed a heart rate mean and standard deviation of 121.16 ± 19.90 and 111.24 ± 9.20 among the endotracheal intubation and laryngeal mask airway groups, respectively
Another study found that a significant increase in mean value was observed among the ETT group [20, 21]. e findings of our study were closely correlated with another multiple clinical studies as hemodynamic changes were less during the LMA placement than during tracheal intubation [22,23,24]. is may be likely due to insertion of an LMA is easier and takes a shorter time as compared to the ETT insertion so that the degree of stimulating sympathetic nervous system was slower and shorter
Summary
Laryngeal mask airway (LMA) and endotracheal tube (ETT) intubation are among the most important artificial airway devices used at the time of general anesthesia [1]. LMA offers a much less invasive way of maintaining airway as it does not pass through glottis. Both are noxious stimuli which elicit transient or marked sympathetic response [2]. Many studies have shown the effect of different combinations of anesthetic drugs on reducing the side effect of tracheal intubation on patients’ hemodynamic parameters [9, 10]. Administering sevoflurane and remifentanil combination did not find significant difference in hemodynamic changes [14]. We compared hemodynamic changes after LMA insertion and endotracheal ETT intubation to find out a better way of controlling the airway
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