Intubating condition, hemodynamic parameters and upper airway morbidity: A comparison of intubating laryngeal mask airway with standard direct laryngoscopy

Jayaram, Kavitha; Tripathy, Debendra Kumar; Mishra, Sandeep Kumar; Mishra, Gayatri; Chandrasekhar, L J; Ezhilarasu, Punitha

doi:10.4103/0259-1162.84190

Cited by 6 publications

(5 citation statements)

References 23 publications

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“…In studies by Kihara, Kavitha and Joe, it was reported that there was no significant difference in pharyngolaryngeal morbidity between intubation using direct laryngoscopy or LMA-Fastrach. In our study, there was no statistically significant difference between the two groups either (Kihara et al, 2000;Joo and Rose, 1999;Kavitha et al, 2011;Kihara et al, 2001).…”

Section: Discussioncontrasting

confidence: 57%

“…Authors suggested that LMA-Fastrach caused stimulation similar to laryngoscopy at peri-laryngeal structures during both insertion and removal (Zhang et al, 2006). Another study compared hemodynamic response and upper respiratory tract morbidity between orotracheal intubation via LMA-Fastrach and direct laryngoscopy (Kavitha et al, 2011). No significant difference was found in hemodynamic response to orotracheal intubation between groups (Kavitha et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

“…Another study compared hemodynamic response and upper respiratory tract morbidity between orotracheal intubation via LMA-Fastrach and direct laryngoscopy (Kavitha et al, 2011). No significant difference was found in hemodynamic response to orotracheal intubation between groups (Kavitha et al, 2011). Sener, et al (2012) compared hemodynamic effects of intubation via direct laryngoscopy and LMA-Fastrach in hypertensive patients.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the Hemodynamic Effects of Intubation via Fastrach Laryngeal Mask Airway with Standard Direct Laryngoscopy in Hypertensive Patients

Göktan¹,

Ülgey²

2023

FMCR

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Background/Aim: In this study, hemodynamic response and postoperative complications of intubation via laryngoscopy compared to laryngeal mask airway were investigated in hypertensive patients. Materials and Methods: Following ethics committee approval, 120 ASA II-III patients (aged 18-65 years) with stage 1 or 2 hypertension who required endotracheal intubation in an elective surgery were randomly assigned into 2 groups. Group L (n = 60) was defined as the direct laryngoscopy in endotracheal intubation group, and Group F (n = 60) used the Fastrach LMA in endotracheal intubation. The HR, SAP, DAP, MAP and SpO2 were recorded at baseline (after premedication by midazolam), after anesthesia induction (when no response was recorded to TOF stimulation), during intubation, and on minutes 0, 1, 2, 3, 4 and 5 after intubation. The patients were transferred to the recovery room after extubation. Patients were asked at the postoperative 30th minute whether they experienced a sore throat or hoarseness. To check pharyngolaryngeal morbidity, sore throat and hoarseness were assessed by a 4-point scale. Results: Demographic characteristics were found to be similar in both groups. Thyromental and sternomental distance and difficulties in mask ventilation were found to be similar. It was found that time to intubation was significantly higher in group F. In group L, the HR, DAP and MAP values increased on minute 0 after intubation when compared to the baseline values and returned to baseline values within one minute. In group F, the HR, SAP, DAP and MAP decreased on minute 0 compared to the baseline. Postoperative morbidity was comparable between the groups. No significant difference was found in sore throat and hoarseness between the groups. Conclusion: Intubation via LMA is more advantageous in alleviating hemodynamic responses. Intubation via direct laryngoscopy is a more rapid method when compared to intubation via LMA. There was no significant difference in upper respiratory tract morbidity between the groups.

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Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Comparison of the Hemodynamic Effects of Intubation via Fastrach Laryngeal Mask Airway with Standard Direct Laryngoscopy in Hypertensive Patients

Göktan¹,

Ülgey²

2023

FMCR

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“…Similar haemodynamic response in both the groups can be attributed to comparable sympatho-adrenal stimulation in response to both SADs. Kavitha J et al [21] in their study found nonsignificant rise in HR and MAP after ILMA insertion and after ET intubation through ILMA, followed by return to baseline at 5 min Both the devices are equally effective in maintaining SpO 2 as there was no episode of desaturation in both the groups .…”

Section: Ilmamentioning

confidence: 84%

Comparison of Endotracheal Intubation Through I-gel and Intubating Laryngeal Mask Airway

Choudhary¹,

Karnawat²,

Mohammed³

et al. 2016

TOATJ

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Background: Supraglottic airway devices (SADs) are very useful airway adjunct in managing anticipated and unanticipated difficult airway and can be used as a ventilating aid and as a conduit for tracheal intubation. The new versions of SADs like i-gel and intubating laryngeal mask airway (ILMA), have advantage of hands-free airway maintenance without the need for tracheal intubation, they can be placed easily without direct visualization of the larynx, ensure predictable ventilation and can be used as conduit for tracheal intubation. Objective: To compare ease and success of placement of both SADs and ease and success of endotracheal (ET) intubation through both SADs. Method: Eighty patients of both sexes, aged between 18-60 years and belonging to ASA grade I and II undergoing surgical procedure under general anaesthesia (GA) were randomly divided into two group (i-gel and ILMA) of equal number. Following induction the allocated device was inserted and after confirming adequate ventilation, blind ET intubation was attempted through the device. First attempt and overall success rate of SAD insertion and ET intubation through SAD; time taken for SAD insertion and ET intubation through SAD; hemodynamic changes and postoperative complications were recorded and compared between groups. Result: Demographic profile, success rate of SAD insertion, haemodynamic changes and adverse effects were similar between groups (p>0.05).Overall time needed for successful SAD insertion was significantly shorter in group i-gel (22.52±5.64 sec) than group ILMA (31.15±5.52 sec) (p value <0.0001). Overall success rate of blind ET intubation was higher in group i-gel (75%) in comparison to group ILMA (65%). I-gel required significantly less time to achieve successful ET intubation than ILMA (26.30±11.35 sec vs. 33.53±13.13 sec)(p<0.0001). Conclusion: Both the SADs were proved to be useful alternative to conventional laryngoscope for ET intubation, although i-gel required lesser time and had better success rate of ET intubation as compared to ILMA.

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“…in 60 patients (63.6 ± 14.1 s. It was noted that lesser the duration of intubation the better was the hemodynamic profile of patients. [11] However, Sharma et al . reported further lesser time to accomplish successful ETT, using ILMA with PVC tubes and also wire-reinforced silicone tubes (14.7 ± 6.2 s and 10.0 ± 4.4 s, respectively).…”

Section: Discussionmentioning

confidence: 99%

Comparison of intubating laryngeal mask airway and fiberoptic bronchoscopy for endotracheal intubation in patients undergoing cervical discectomy

Chalam

Gupta

2016

J Anaesthesiol Clin Pharmacol

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Background and Aims:Direct laryngoscopy is hazardous in patients with cervical posterior intervertebral disc prolapse (PIVD) as it may worsen the existing cord compression. To achieve smooth intubation, many adjuncts such as fiberoptic bronchoscope (FOB), video laryngoscopes, lighted stylets, and intubating laryngeal mask airways (ILMAs) are available. However, there is a paucity of literature comparing ILMA with fiberoptic intubation in patients with PIVD. Hence, this study was designed to compare the effectiveness of ILMA technique with FOB to accomplish endotracheal intubation in patients undergoing cervical discectomy.Material and Methods:Sixty patients of age group 20–60 years, of American Society of Anesthesiologists status I or II, were enrolled in this prospective and randomized study. They were allocated to one of the two groups, ILMA group and FOB group. The patients were intubated orally using either equipment, after dexmedetomidine premedication and induction of general anesthesia. Chi-square and Fisher exact tests were used to find the significance of study parameters on a categorical scale. Paired samples t-test and Student's t-test were used to find the significance of study parameters on a continuous scale. Significance was assessed at 5% level of significance.Results:Bronchoscopy was a faster method of securing airway as compared with ILMA (38.13 ± 11.52 vs. 29.83 ± 13.75 s). Tracheal intubation was successful in all 60 patients (100%), belonging to both groups.Conclusion:ILMA and FOB were comparable with regards to ease of intubation in terms of time, the number of attempts and hemodynamic stability.

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Intubating condition, hemodynamic parameters and upper airway morbidity: A comparison of intubating laryngeal mask airway with standard direct laryngoscopy

Cited by 6 publications

References 23 publications

Comparison of the Hemodynamic Effects of Intubation via Fastrach Laryngeal Mask Airway with Standard Direct Laryngoscopy in Hypertensive Patients

Comparison of the Hemodynamic Effects of Intubation via Fastrach Laryngeal Mask Airway with Standard Direct Laryngoscopy in Hypertensive Patients

Comparison of Endotracheal Intubation Through I-gel and Intubating Laryngeal Mask Airway

Comparison of intubating laryngeal mask airway and fiberoptic bronchoscopy for endotracheal intubation in patients undergoing cervical discectomy

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