Comparative evaluation of hemodynamic response with intubating laryngeal mask airway and intubation with Macintosh Blade- A prospective study

Background: Direct laryngoscopy and intubation leads to elevated hemodynamic responses which should be attenuated by either by medication or by modifying technique by using alternative endotracheal tube guiding devices. Intubating Laryngeal Mask Airway (ILMA) can lessen the hemodynamic response of endotracheal intubation. The present study was designed to compare the hemodynamic responses during intubation by direct laryngoscopy and during ILMA. Material methods: After Ethical Committee approval, eighty adult consented patients of ASA grade I/II aged 18-60 years of either sex, undergoing elective surgeries under general anaesthesia were randomized into two groups using sealed envelopes. Patients of Group I- were intubated by using ILMA and patients of Group M were intubated by using Macintosh laryngoscope. The general anaesthesia technique was standardized. Heart rate, systolic and diastolic blood pressure and any another complications were noted at various time intervals for statistical analysis, using one way ANOVA and chi square test. P value of <0.05 was considered statistically significant. Results: Demographic profile was comparable. The mean time taken with the ILMA was 85.25 ± 13.19 seconds and was only 17.25 ± 9.74 seconds using the Macintosh laryngoscope with p=0.001. The baseline heart rate was comparable but post intubation till 5 minutes, it was statistically significant. Systolic blood pressure between Group I and Group M were also compared and the p-values were statistically highly significant after intubation at immediate post intubation. There was significant difference in rise in diastolic blood pressure between groups. No statistically significant difference between the two groups with regards to complications was observed. Conclusion: ILMA is a safer alternative to Macintosh laryngoscope as ILMA attenuated the hemodynamic stress responses to tracheal intubation and may be preferred in hypertensive patients.