Comparison of the Flexi laryngeal mask airway vs. endotracheal intubation for paediatric ophthalmic surgery

The study aims at assessing the advantages of Flexi laryngeal mask airway (Flexi LMA) over endotracheal intubation in minimizing the pressor response as well as the rise in intraocular pressure in paediatric patients undergoing ophthalmic operations. Method: Sixty paediatric patients aged 4-12 years of ASA grade I and II meant for ophthalmic surgeries were divided into two groups of 30 patients each by a computer generated table. Group I patients underwent Flexi Laryngeal mask airway insertion and group II patients received endotracheal intubation. All the patients received similar premedication and anaesthetic drugs on per kg body weight basis. Patients were induced with Propofol and were maintained on Oxygen, nitrous oxide, Sevoflurane and rocuronium bromide. Changes in heart rate, mean arterial pressure and intraocular pressure were noted at different intervals which were markedly different in the two groups. Values so obtained were analysed using students t test and Z test respectively. A p value < 0.05 was considered to be statistically significant. Results: Similar but marked attenuated pattern of response was seen in group I patients compared to group II patients. Statistically significant difference between the two groups were seen in mean arterial blood pressure, heart rate and intra-ocular pressure(p < 0.05). Conclusion: Thus the use of Flexi LMA may offer some noticeable advantages over endotracheal intubation, especially for glaucoma patients as well as for those with some other associated congenital anomaly like congenital heart disease, cerebral aneurysm or even for valvular diseases.