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Better Hemodynamic Profile of Laryngeal Mask Airway Insertion Compared to Laryngoscopy and Tracheal Intubation.

Jarineshin H, Kashani S, Vatankhah M, Abdulahzade Baghaee A, Sattari S, Fekrat F - Iran Red Crescent Med J (2015)

Bottom Line: The mean ± SD of SBPs (105.62 ± 12.12, 112.90 ± 12.2, and 112.48 ± 15.14 mm Hg, respectively for ETT, LMA-C, and LMA-S) and DBPs (64.64 ± 10.23, 73.78 ± 9.70, and 71.20 ± 12.27 mm Hg, respectively for ETT, LMA-C, and LMA-S) were significantly lower in the ETT group compared to LMA groups 5 minutes after device insertion (P < 0.01 for SBPs and P < 0.001 for DBPs); however these values were lower than the baseline values in all groups.There were no significant differences between the LMA-C and LMA-S groups in terms of hemodynamic parameters.Maintaining the airway using laryngeal mask airway is associated with less cardiovascular responses compared to direct laryngoscopy and tracheal intubation.

View Article: PubMed Central - PubMed

Affiliation: Anesthesiology, Critical Care and Pain Management Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, IR Iran.

ABSTRACT

Background: Laryngoscopy and tracheal intubation can cause serious cardiovascular responses in patients such as hypertension, tachycardia, and arrhythmias. Alternative airway maintenance techniques may attenuate these hemodynamic stress responses.

Objectives: This study aimed to compare the immediate hemodynamic effects of the insertion of laryngeal mask airway supreme (LMA-S) and classic (LMA-C) with laryngoscopy and Endotracheal Intubation (ETT).

Patients and methods: This study was a prospective, double-blind, and randomized clinical trial conducted on 150 patients aged 18 to 50 years with ASA I (American Society of Anesthesiologists), in the general operating room of Shahid Mohammadi hospital, Hormozgan university of medical sciences, Bandar Abbas, Iran. In the ETT group, endotracheal intubation was performed using the Macintosh laryngoscope; while for the LMA-C and LMA-S groups, LMA Classic and LMA Supreme were inserted, respectively. The induction and maintenance of anesthesia were similar in all patients. The hemodynamic parameters such as heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured before (baseline) and after induction of anesthesia at 4 different time points. The statistical analysis was done and P value less than 0.05 was considered significant.

Results: Participants in all groups were similar in terms of gender, age, weight, height, and Mallampati class. The mean ± SD of SBPs (105.62 ± 12.12, 112.90 ± 12.2, and 112.48 ± 15.14 mm Hg, respectively for ETT, LMA-C, and LMA-S) and DBPs (64.64 ± 10.23, 73.78 ± 9.70, and 71.20 ± 12.27 mm Hg, respectively for ETT, LMA-C, and LMA-S) were significantly lower in the ETT group compared to LMA groups 5 minutes after device insertion (P < 0.01 for SBPs and P < 0.001 for DBPs); however these values were lower than the baseline values in all groups. There were no differences in the mean SBP and DBPs between the three groups at the other time points. The mean ± SD heart rates in the ETT group, compared to the LMA-C and LMA-S groups, were considerably higher in the first minute (100.06 ± 18.27, 82.50 ± 10.52, and 82.00 ± 13.60 bpm, respectively for ETT, LMA-C, and LMA-S), third minute (91.04 ± 17.12, 78.84 ± 11.23, and 78.90 ± 13.41 bpm, respectively for ETT, LMA-C, and LMA-S) and fifth minute (85.82 ± 16.01, 75.78 ± 11.73, and 75.04 ± 13.90 bpm, respectively for ETT, LMA-C, and LMA-S) after intubation (P < 0.001). There were no significant differences between the LMA-C and LMA-S groups in terms of hemodynamic parameters.

Conclusions: Maintaining the airway using laryngeal mask airway is associated with less cardiovascular responses compared to direct laryngoscopy and tracheal intubation.

No MeSH data available.


Related in: MedlinePlus

Flow Diagram of Patients RecruitmentGroup ETT: laryngoscopy and endotracheal intubation, group LMA-C: laryngoscopy mask airway classic, group LMA-S: laryngeal mask airway supreme
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fig21849: Flow Diagram of Patients RecruitmentGroup ETT: laryngoscopy and endotracheal intubation, group LMA-C: laryngoscopy mask airway classic, group LMA-S: laryngeal mask airway supreme

Mentions: The sample size n was calculated from λ considering that α = 0.05, β = 0.1, σ = √MSE = 9.01, and an uneven distribution of κ, which was two times 12.66. By calculating Δ, the size of sample for each group was found as 50 (NCSS software). A number of 180 patients were assessed eligible and enrolled into the study, but 30 participants were excluded according to the flow chart (Figure 1).


Better Hemodynamic Profile of Laryngeal Mask Airway Insertion Compared to Laryngoscopy and Tracheal Intubation.

Jarineshin H, Kashani S, Vatankhah M, Abdulahzade Baghaee A, Sattari S, Fekrat F - Iran Red Crescent Med J (2015)

Flow Diagram of Patients RecruitmentGroup ETT: laryngoscopy and endotracheal intubation, group LMA-C: laryngoscopy mask airway classic, group LMA-S: laryngeal mask airway supreme
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4587401&req=5

fig21849: Flow Diagram of Patients RecruitmentGroup ETT: laryngoscopy and endotracheal intubation, group LMA-C: laryngoscopy mask airway classic, group LMA-S: laryngeal mask airway supreme
Mentions: The sample size n was calculated from λ considering that α = 0.05, β = 0.1, σ = √MSE = 9.01, and an uneven distribution of κ, which was two times 12.66. By calculating Δ, the size of sample for each group was found as 50 (NCSS software). A number of 180 patients were assessed eligible and enrolled into the study, but 30 participants were excluded according to the flow chart (Figure 1).

Bottom Line: The mean ± SD of SBPs (105.62 ± 12.12, 112.90 ± 12.2, and 112.48 ± 15.14 mm Hg, respectively for ETT, LMA-C, and LMA-S) and DBPs (64.64 ± 10.23, 73.78 ± 9.70, and 71.20 ± 12.27 mm Hg, respectively for ETT, LMA-C, and LMA-S) were significantly lower in the ETT group compared to LMA groups 5 minutes after device insertion (P < 0.01 for SBPs and P < 0.001 for DBPs); however these values were lower than the baseline values in all groups.There were no significant differences between the LMA-C and LMA-S groups in terms of hemodynamic parameters.Maintaining the airway using laryngeal mask airway is associated with less cardiovascular responses compared to direct laryngoscopy and tracheal intubation.

View Article: PubMed Central - PubMed

Affiliation: Anesthesiology, Critical Care and Pain Management Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, IR Iran.

ABSTRACT

Background: Laryngoscopy and tracheal intubation can cause serious cardiovascular responses in patients such as hypertension, tachycardia, and arrhythmias. Alternative airway maintenance techniques may attenuate these hemodynamic stress responses.

Objectives: This study aimed to compare the immediate hemodynamic effects of the insertion of laryngeal mask airway supreme (LMA-S) and classic (LMA-C) with laryngoscopy and Endotracheal Intubation (ETT).

Patients and methods: This study was a prospective, double-blind, and randomized clinical trial conducted on 150 patients aged 18 to 50 years with ASA I (American Society of Anesthesiologists), in the general operating room of Shahid Mohammadi hospital, Hormozgan university of medical sciences, Bandar Abbas, Iran. In the ETT group, endotracheal intubation was performed using the Macintosh laryngoscope; while for the LMA-C and LMA-S groups, LMA Classic and LMA Supreme were inserted, respectively. The induction and maintenance of anesthesia were similar in all patients. The hemodynamic parameters such as heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured before (baseline) and after induction of anesthesia at 4 different time points. The statistical analysis was done and P value less than 0.05 was considered significant.

Results: Participants in all groups were similar in terms of gender, age, weight, height, and Mallampati class. The mean ± SD of SBPs (105.62 ± 12.12, 112.90 ± 12.2, and 112.48 ± 15.14 mm Hg, respectively for ETT, LMA-C, and LMA-S) and DBPs (64.64 ± 10.23, 73.78 ± 9.70, and 71.20 ± 12.27 mm Hg, respectively for ETT, LMA-C, and LMA-S) were significantly lower in the ETT group compared to LMA groups 5 minutes after device insertion (P < 0.01 for SBPs and P < 0.001 for DBPs); however these values were lower than the baseline values in all groups. There were no differences in the mean SBP and DBPs between the three groups at the other time points. The mean ± SD heart rates in the ETT group, compared to the LMA-C and LMA-S groups, were considerably higher in the first minute (100.06 ± 18.27, 82.50 ± 10.52, and 82.00 ± 13.60 bpm, respectively for ETT, LMA-C, and LMA-S), third minute (91.04 ± 17.12, 78.84 ± 11.23, and 78.90 ± 13.41 bpm, respectively for ETT, LMA-C, and LMA-S) and fifth minute (85.82 ± 16.01, 75.78 ± 11.73, and 75.04 ± 13.90 bpm, respectively for ETT, LMA-C, and LMA-S) after intubation (P < 0.001). There were no significant differences between the LMA-C and LMA-S groups in terms of hemodynamic parameters.

Conclusions: Maintaining the airway using laryngeal mask airway is associated with less cardiovascular responses compared to direct laryngoscopy and tracheal intubation.

No MeSH data available.


Related in: MedlinePlus