“Hemodynamic Changes Between Endotracheal Intubation And Laryngeal Mask Airway Insertion”

Abstract

Introduction: Haemodynamic stability is an important aspect to the anaesthesiologist for the benefit of the patients especially during intubations, laryngeal mask insertion. Laryngoscopy and endotracheal intubation can cause striking changes in Haemodynamics as result of intense stimulation of sympathetic nervous system. Airway management is a crucial skill for the clinical anesthesiologist. Objective: To evaluate the hemodynamic changes between endotracheal intubation and laryngeal mask airway insertion. Material and Methods: This was prospective observational study conducted in Dept. Of Anesthesiology, 250 Bedded Shaheed Shaikh Abu Naser Specialized Hospital, Khulna, Bangladesh from July to December 2020. This was a prospective observational study on 52 patients of ASA I-II status divided into 2 groups of 26 each. In the ETT (Endotracheal tube) group endotracheal intubation was done using Macintosh laryngoscope by using portex cuffed endotracheal while in LMA (Laryngeal mask airway) group laryngeal mask airway was inserted according to the standard recommendation. Heart rate, Systolic, Diastolic and Mean arterial pressure and dysrhythmias were monitored. Results: The two groups were comparable in terms of demographic data as there were no significant differences between the 2 groups in terms of age, sex, duration of surgery, ASA grades and MPC classification. Heart rate (HR), Systolic blood pressure (SBP), Diastolic blood pressure (DBP), Mean arterial pressure (MAP) remains on higher side in ETT group than LMA group which was statistically significant. P<0.05. Dysrhythmias were noted in 2 patients of ETT group while LMA group did not notice any dysrhythmias. Conclusion: In conclusion the demonstrated that there is a haemodynamic response consisting of an increase in Heart rate, SBP, DBP and MAP that comes with ETT insertion as well as with LMA insertion. However, the response caused by ETT insertion is significantly greater than that caused by LMA insertion.