Comparative study between laryngeal mask airway and endotracheal tube as regard the effect on intraocular pressure and hemodynamic response in pediatrics undergoing congenital glaucoma surgery

Document Type : Original Article

Authors

1 Department of anesthesia and ICU, Sohage University, sohage, Egypt

2 Department, of Anesthesia & Intensive Care, Fuculty of Medicine, Sohag University.

Abstract

Background:This study aims to compare both endotracheal (ETT) tube and laryngeal mask airway (LMA) as a conduit for continuous ventilation during general anaesthesia as regard their effect on the hemodynamic response and intraocular pressure (IOP) after their insertion intra operative in pediatric patients undergoing congenital glaucoma surgery.
Methods:Patients were divided into two groups of 25 patients each. Group I; patients who were subjected to LMA insertion group II ;patients who were subjected to conventional laryngoscopy and endotracheal intubation .
Results:The result of our study demonstrated that there was high significant differences between LMA insertion and endotracheal intubation as regard hemodynamic responses; Heart rate increased after insertion of ETT in (group II), HR (p value <0.05) and continued until 2 min after insertion. Also, there was a significant difference in the mean blood pressure after insertion in ETT group (p value <0.05), BP continued to be elevated until 3 min after insertion. As regard IOP in our study, we noted that there was no difference between two group at base line but there was a significant increase in the intraocular pressure after insertion in ETT group when compared with LMA group (p value<0.05), and continued until 3 min after insertion then regressing without significant difference between both groups all over the procedure,  after removal of both devices ,there was increase in IOP measurement in both groups but the increase was insignificantly different between both groups  (p value >0.05) . As regard complications, in our study fewer complications occurred after removal of both devices ; as coughing in two cases (8%) in LMA group compared with six cases (28%) in ETT group, two cases (2%) had straining in LMA group compared with seven cases (28%) in ETT group  ,one case (4%) had laryngospasm in ETT group  with no significant difference between the two groups (p. value>0.05), also we noticed that complications as airways trauma, aspiration and gas leakage didn’t occur.
Conclusion:Laryngeal Mask Airway was better than endotracheal intubation when used as a conduit for airway management; it had less hemodynamic responses and changes in the IOP.

References

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Sohag Medical Journal
Volume 21, Issue 3
October 2017
Pages 543-552

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