The pressor response and laryngeal mask insertion

Braude, N.; Clements, Elizabeth; Hodges, U.M.; Andrews, Benjamin P.

doi:10.1111/j.1365-2044.1989.tb11439.x

Cited by 150 publications

(66 citation statements)

References 8 publications

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“…One possible advantage of its use is that insertion of the LMA is associated with a lesser haemodynamic response compared with conventional laryngoscopy and tracheal intubation [3]. To date this has been documented by one study [4], but the authors employed only intermittent measurement of arterial pressure and used an oral airway as part of the technique; this has been shown to be associated with similar cardiovascular responses to those produced by the LMA itself [S], and may have caused difficulty in interpretation of the data. In contrast, Griffin and colleages [6] found no difference in mean systolic arterial pressure and heart rate response between tracheal intubation and LMA insertion.…”

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confidence: 99%

Cardiovascular responses to insertion of the laryngeal mask

et al. 1992

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SummaryWe have compared, in 40 healthy patients, the cardiovascular responses induced by laryngoscopy and intubation with those produced by insertion of a laryngeal mask. Anaesthesia was induced with thiopentone and maintained with enjlurane and nitrous oxide in oxygen; vecuronium was used for muscle relaxation. Arterial pressure was measured with a Finapres monitor. The mean maximum increase in systolic arterial pressure after laryngoscopy and tracheal intubation was 51.3% compared with 22.9% for laryngeal mask insertion ( p < 0.01). Increases in maximum heart rate were similar, (26.6% v 25.7%) although heart rate remained elevated for longer after tracheal intubation. We conclude that insertion of the laryngeal mask airway is accompanied by smaller cardiovascular responses than those after laryngoscopy and intubation and that its use may be indicated in those patients in whom a marked pressor response would be deleterious.

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confidence: 99%

Cardiovascular responses to insertion of the laryngeal mask

et al. 1992

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“…Another study by N. Brande & E.A.F. 5 Clements studied the cardiovascular response induced by laryngoscopy and intubation and that with laryngeal mask airway in 24 and 23 healthy patients respectively. The study showed a maximum mean increase in systolic blood pressure of 17.1% and 8.6% in endotracheal tube & laryngeal mask airway group respectively.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Hemodynamic Responses and Postoperative Airway Complications between ET Tube and LMA in Pediatric Short Surgical Procedures

Kumar¹

2015

jmscr

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9%, 11.9%, 7.9%, 2.1% above baseline in group T and 3.6%, 5.2%, 5.3%, 5.4% below baseline for group L. The DBP were 11.2%, 8.9%, 5.6%, 2.1% above baseline in group T and in 3.2%, 5.1%, 5.6%,6.2% below baseline for group L. The incidence of post operative sore throat was 8% in group L and in 20% in group T. Conclusions: Laryngeal mask airway is a valuable and better alternative to endotracheal intubation in securing the airway, especially in pediatric patients in whom pressor response to endotracheal intubation is detrimental.

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“…Compared to tracheal intubation and extubation, the use of SADs is associated with more stability in hemodynamics, 15 intracranial pressure, 16 and intraocular pressure. [17][18][19] There is a lower incidence of emergence cough and postoperative sore throat with SADs.…”

Section: Alternative To Tracheal Intubation For Routine Anesthesiamentioning

confidence: 99%

Supraglottic Airway DevicesDiscussion

Ramachandran

Kumar

2014

Respir Care

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SummarySupraglottic airway devices (SADs) are used to keep the upper airway open to provide unobstructed ventilation. Early (first-generation) SADs rapidly replaced endotracheal intubation and face masks in > 40% of general anesthesia cases due to their versatility and ease of use. Second-generation devices have further improved efficacy and utility by incorporating design changes. Individual second-generation SADs have allowed more dependable positive-pressure ventilation, are made of disposable materials, have integrated bite blocks, are better able to act as conduits for tracheal tube placement, and have reduced risk of pulmonary aspiration of gastric contents. SADs now provide successful rescue ventilation in > 90% of patients in whom mask ventilation or tracheal intubation is found to be impossible. However, some concerns with these devices remain, including failing to adequately ventilate, causing airway damage, and increasing the likelihood of pulmonary aspiration of gastric contents. Careful patient selection and excellent technical skills are necessary for successful use of these devices.

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The pressor response and laryngeal mask insertion

Abstract: SummaryThe pressor response associated with laryngoscopy and tracheal intubation may be harmful to certain patients.

Cited by 150 publications

References 8 publications

Cardiovascular responses to insertion of the laryngeal mask

Cardiovascular responses to insertion of the laryngeal mask

Comparison of Hemodynamic Responses and Postoperative Airway Complications between ET Tube and LMA in Pediatric Short Surgical Procedures

Supraglottic Airway DevicesDiscussion

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