Haemodynamic response to tracheal intubation via intubating laryngeal mask airway versus direct laryngoscopic tracheal intubation

To compare the haemodynamic response to tracheal intubation using either direct larygoscopy or Intubating Laryngeal Mask Airway. This was a prospective randomized controlled trial. One hundred adult ASA-I and ASA-II patients coming to the Anaesthesia Department of Aga Khan University Hospital were randomly divided into two groups. In group-I endotracheal intubation was done with the help of Macintosh laryngoscope while in group-II patients were intubated with the help of the Intubating Laryngeal Mask Airway. Systolic, diastolic, mean arterial blood pressure and heart rate were recorded at baseline, at laryngoscopy and at 1 minute interval for 10 minutes following intubation. There was no statistically significant difference between the groups with respect to age, weight, height and gender. The rise in systolic blood pressure in group-I was 26 and 13% when compared with the baseline for first two minutes, while in group II the increase was 8-12%. When both groups were compared statistically significant difference (P < 0.05) was observed. The rise in diastolic blood pressure was 23% and 7% in group-I and II respectively when compared with the baseline. Statistically significant difference (P < 0.05) was observed at first two minutes following intubation between the two groups. The rise in mean arterial blood pressure after intubation was statistically significant. The increase in heart rate was observed after intubation in both the groups and when both the groups were compared the rise was not statistically significant. We concluded that intubation through intubating laryngeal mask airway is accompanied by minimal cardiovascular responses than those associated with direct laryngoscopic tracheal intubation, so it can be used for patients in whom a marked pressor response would be deleterious.