The pressor response and laryngeal mask insertion

The pressor response associated with laryngoscopy and tracheal intubation may be harmful to certain patients. The laryngeal mask airway avoids the need for laryngoscopy and allows positive pressure ventilation of the lungs in appropriate patients. This study compared the pressor response of tracheal intubation with that of mask insertion in two groups of 24 and 23 healthy patients respectively. All patients were anaesthetised with thiopentone, nitrous oxide, enflurane and paralysed with atracurium. We have shown a similar, but attenuated pattern of response associated with mask insertion in comparison with laryngoscopy and intubation; significant differences between the groups were evident in arterial diastolic blood pressure immediately after insertion and again 2 minutes later. Use of the laryngeal mask may therefore offer some limited advantages over tracheal intubation in the anaesthetic management of patients where the avoidance of the pressor response is of particular concern.