To evaluate the stress response to tracheal intubation by macintosh laryngoscope and intubating laryngeal mask airway

Somika Agarwal; Sapna Bansal

Abstract

Observational Study

To evaluate the stress response to tracheal intubation by macintosh laryngoscope and intubating laryngeal mask airway

Somika Agarwal* and Sapna Bansal

Published: 19 December, 2022 | Volume 6 - Issue 1 | Pages: 007-013

Aim: To evaluate the hemodynamic changes and side effects during endotracheal intubation with Macintosh laryngoscope and intubating laryngeal mask airway.
Materials and methods: A prospective, simple randomized, comparative study on 100 patients 18 years - 60 years of age, divided into two groups: Group A comprising intubation with Macintosh laryngoscope and Group B intubation through ILMA.
Results: Total intubation time (in seconds) of group A was 24.38 + 3.26 seconds and of the group, B was 42.94 + 1.24 seconds. At 2,4 and 6, a higher rise in mean heart rate was noted in group A (p < 0.05). At 2,4,6 and 8 minutes difference in mean SBP and mean DBP of the two groups was statistically significant with a p - value of < 0.05 with a significant increase of mean SBP and mean DBP in patients of group A. The difference for all complications was not significant between the two groups.
Conclusion: Intubation via intubating laryngeal mask airway can be done as an alternative to direct laryngoscopy using a Macintosh blade as intubation via intubating laryngeal mask airway has shown to have lesser hemodynamic changes.

Read Full Article HTML DOI: 10.29328/journal.ijcar.1001020 Cite this Article Read Full Article PDF

Keywords:
Hemodynamic parameters; Intubating laryngeal mask airway; Macintosh laryngoscope

References

Buhari FS, Selvaraj V. Randomized controlled study comparing the hemodynamic response to laryngoscopy and endotracheal intubation with McCoy, Macintosh, and C-MAC laryngoscopes in adult patients. J Anaesthesiol Clin Pharmacol. 2016 Oct-Dec;32(4):505-509. doi: 10.4103/0970-9185.194766. PMID: 28096584; PMCID: PMC5187618.
Brain AI, Verghese C, Addy EV, Kapila A. The intubating laryngeal mask. I: Development of a new device for intubation of the trachea. Br J Anaesth. 1997 Dec;79(6):699-703. doi: 10.1093/bja/79.6.699. PMID: 9496198.
Altun D, Ali A, Çamcı E, Özonur A, Seyhan TÖ. Haemodynamic Response to Four Different Laryngoscopes. Turk J Anaesthesiol Reanim. 2018 Dec;46(6):434-440. doi: 10.5152/TJAR.2018.59265. Epub 2018 Sep 6. PMID: 30505605; PMCID: PMC6223868.
Kihara S, Watanabe S, Taguchi N, Suga A, Brimacombe JR. A comparison of blind and lightwand-guided tracheal intubation through the intubating laryngeal mask. Anaesthesia. 2000 May;55(5):427-31. doi: 10.1046/j.1365-2044.2000.01324.x. PMID: 10792132.
Stone DJ, Gal TJ. Airway Management. In Miller RD ed. Anesthesia. 5th ed. Churchill Livingstone New York. 2000; 39:1444-5.
Kovac AL. Controlling the hemodynamic response to laryngoscopy and endotracheal intubation. J Clin Anesth. 1996 Feb;8(1):63-79. doi: 10.1016/0952-8180(95)00147-6. PMID: 8695083.
Pollard BJ, Norton ML. Principles of Airway Management, In: Wylie and Churchill – Davidson’s, A Practice of Anesthesia (7th Edn) 2003; 28: 445-6.
Rosenblatt WH. Airway Management. In: Barash PG, Cullen BF, Stoelting RK. Clinical Anesthesia (4th Edn). 2001; 23: 599-605.
Kahl M, Eberhart LH, Behnke H, Sänger S, Schwarz U, Vogt S, Moosdorf R, Wulf H, Geldner G. Stress response to tracheal intubation in patients undergoing coronary artery surgery: direct laryngoscopy versus an intubating laryngeal mask airway. J Cardiothorac Vasc Anesth. 2004 Jun;18(3):275-80. doi: 10.1053/j.jvca.2004.03.005. PMID: 15232805.
Bharti N. Clinical investigation ease of insertion and haemodynamic effects following tracheal intubation using intubating laryngeal mask airway: a comparison with conventional macintosh laryngoscope Indian J. Anaesth. 2006; 50: 205-8.
Kavitha J, Tripathy DK, Mishra SK, Mishra G, Chandrasekhar LJ, Ezhilarasu P. Intubating condition, hemodynamic parameters and upper airway morbidity: A comparison of intubating laryngeal mask airway with standard direct laryngoscopy. Anesth Essays Res. 2011 Jan-Jun;5(1):48-56. doi: 10.4103/0259-1162.84190. PMID: 25885300; PMCID: PMC4173360.
Rastogi B, Singh VP, Gandhi A, Jain M, Gupta K, Singh M, et al. Comparative evaluation of hemodynamic response with intubating laryngeal mask airway and intubation with Macintosh Blade- A prospective study. Glob Anaesth Perioper Med. 2015; 1: 34-9.
Sharma MU, Gombar S, Gombar KK, Singh B, Bhatia N. Endotracheal intubation through the intubating laryngeal mask airway (LMA-Fastrach™): A randomized study of LMA- Fastrach™ wire-reinforced silicone endotracheal tube versus conventional polyvinyl chloride tracheal tube. Indian J Anaesth. 2013 Jan;57(1):19-24. doi: 10.4103/0019-5049.108555. PMID: 23716761; PMCID: PMC3658329.
Abdel Fattah MM. Comparison of hemodynamic response to tracheal intubation with laryngoscope versus intubating laryngeal mask airway in elderly hypertensive patients. Ain-Shams J Anaesthesiol. 2016; 9:34-8.
Rastogi B, Singh VP, Gandhi A, Jain M, Gupta K, Singh M, et al. Comparative evaluation of hemodynamic response with intubating laryngeal mask airway and intubation with Macintosh Blade- A prospective study. Glob Anaesth Perioper Med. 2015; 1: 34-9.
Kihara S, Brimacombe J, Yaguchi Y, Watanabe S, Taguchi N, Komatsuzaki T. Hemodynamic responses among three tracheal intubation devices in normotensive and hypertensive patients. Anesth Analg. 2003 Mar;96(3):890-895. doi: 10.1213/01.ANE.0000048706.15720.C9. PMID: 12598280.
Siddiqui NT, Khan FH. Haemodynamic response to tracheal intubation via intubating laryngeal mask airway versus direct laryngoscopic tracheal intubation. J Pak Med Assoc. 2007 Jan;57(1):11-4. PMID: 17319412.
Gamil S, Gafaar T, Farid D, Amin O. Intubation Characteristics and Stress Responses during Endotracheal Intubation by Intubating Laryngeal Mask Airway versus Macintosh Laryngoscope in Controlled Hypertensive Patients. Zagazig University Medical Journal. 2019; 14: 45-9.
Wilson IG, Fell D, Robinson SL, Smith G. Cardiovascular response to insertion of the laryngeal mask. Anesthesia. 1992; 47:200–2.
Aziz L, Bashir K. Comparison of armoured laryngeal mask airway with endotracheal tube for adenotonsillectomy. J Coll Physicians Surg Pak. 2006 Nov;16(11):685-8. PMID: 17052415.
Jarineshin H, Kashani S, Vatankhah M, Abdulahzade Baghaee A, Sattari S, Fekrat F. Better Hemodynamic Profile of Laryngeal Mask Airway Insertion Compared to Laryngoscopy and Tracheal Intubation. Iran Red Crescent Med J. 2015 Aug 12;17(8):e28615. doi: 10.5812/ircmj.28615. PMID: 26430529; PMCID: PMC4587401.
Sener EB, Ustun E, Ustun B, Sarihasan B. Hemodynamic responses and upper airway morbidity following tracheal intubation in patients with hypertension: conventional laryngoscopy versus an intubating laryngeal mask airway. Clinics (Sao Paulo). 2012;67(1):49-54. doi: 10.6061/clinics/2012(01)08. PMID: 22249480; PMCID: PMC3248601.
Hamaya Y, Dohi S. Differences in cardiovascular response to airway stimulation at different sites and blockade of the responses by lidocaine. Anesthesiology. 2000 Jul;93(1):95-103. doi: 10.1097/00000542-200007000-00018. PMID: 10861151.
Wong JK, Tongier WK, Armbruster SC, White PF. Use of the intubating laryngeal mask airway to facilitate awake orotracheal intubation in patients with cervical spine disorders. J Clin Anesth. 1999 Jun;11(4):346-8. doi: 10.1016/s0952-8180(99)00052-5. PMID: 10470641.
Masoomeh T, Mohammed A, Almadi M. Hemodynamic changes occurring with tracheal intubation by direct laryngoscopy compared with intubating laryngeal mask airway in adults: a random comparison trial. Egypt J Anesthesia. 2013; 29:103-7.
Abdel Fattah MM. Comparison of hemodynamic response to tracheal intubation with laryngoscope versus intubating laryngeal mask airway in elderly hypertensive patients. Ain-Shams J Anaesthesiol. 2016; 9:34-8.
Modir H, Moshiri E, Malekianzadeh B, Noori G, Mohammadbeigi A. Endotracheal intubation in patients with difficult airway: using laryngeal mask airway with bougie versusvideo laryngoscopy. Med Gas Res. 2017 Oct 17;7(3):150-155. doi: 10.4103/2045-9912.215744. PMID: 29152207; PMCID: PMC5674652.
Joo HS, Kapoor S, Rose DK, Naik VN. The intubating laryngeal mask airway after induction of general anesthesia versus awake fiberoptic intubation in patients with difficult airways. Anesth Analg. 2001 May;92(5):1342-6. doi: 10.1097/00000539-200105000-00050. PMID: 11323374.
Dimitriou V, Voyagis GS, Brimacombe JR. Flexible lightwand-guided tracheal intubation with the intubating laryngeal mask Fastrach in adults after unpredicted failed laryngoscope-guided tracheal intubation. Anesthesiology. 2002 Feb;96(2):296-9. doi: 10.1097/00000542-200202000-00012. PMID: 11818759.

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