A Randomised Controlled Trial on Haemodynamic and Intraocular Pressure Changes: A Comparison between Classic Laryngeal Mask Airway and Endotracheal Intubation
Journal Title: Journal of Clinical and Diagnostic Research - Year 2019, Vol 13, Issue 2
Abstract
ABSTRACT Introduction: Laryngeal Mask Airway (LMA) and endotracheal intubation are two methods of securing airway. Insertion of airway devices causes haemodynamic and Intraocular Pressure (IOP) changes. In the present study, authors compared the two devices and the changes they cause. The mechanism of IOP rise is secondary to increased sympathetic activity. In addition, adrenergic stimulation can also produce an acute increase in IOP, by increasing the resistance to the outflow of aqueous humour in trabecular meshwork between anterior chamber and Schlemn’s canal. Aim: To compare the effects of LMA placement and endotracheal intubation on haemodynamics and IOP. Materials and Methods: Sixty patients of American Statistical Association (ASA) Status 1 or 2 undergoing general anaesthesia were included in study. They were divided into two groups, Group 1 in which classic LMA was used and Group 2, in which endotracheal tube was used. All patients were given general anaesthesia following preoxygenation. Pre-airway manipulation haemodynamics and IOP were measured followed by measurement at one, two, three minutes post airway manipulation. The change in heart rate, systolic pressure, diastolic pressure, mean pressure and IOP was calculated by subtracting the actual values from those obtained post-induction. After the surgery, when the patient was fully awake trachea was extubated or LMA was removed whichever the case may be. Results: The change in haemodynamic variables at one, two, three minutes in the intubation group was more and was statistically significant. The maximum change in haemodynamics occurred at one minute after airway manipulation. Though there was an increase in IOP in both groups, this was comparable and hence statistically not significant. The IOP in both the groups remained within the normal range even after airway manipulation. Conclusion: In a patient who can tolerate the transient haemodynamic change an endotracheal intubation should not be a contraindication when minimal changes in IOP do not matter much.
Authors and Affiliations
Madhusudan Upadya, Gaurang Kothari, Julie C R Misquith, Shishir Upadya, Snighda Raja
Keywords
Related Articles
- EP ID EP579786
- DOI 10.7860/JCDR/2019/38198.12528
- Views 75
- Downloads 0
Ways and Means to Utilize Private Practitioners for Tuberculosis Care in India
The growing interest of utilizing the private practitioners in improving the outreach of public health services including Tuberculosis (TB) control programme stemmed out of people’s preference for private health faciliti...
A Comparative Study of Liquid Nitrogen Cryotherapy as Monotherapy versus in Combination with Podophyllin in the Treatment of Condyloma Acuminata
Introduction: Condyloma Acuminata (CA) is a common viral sexually transmitted disease. Although various treatment modalities are available for treating CA, but none of them can achieve 100% response rate. In a search for...
Post-approval Surveillance on Safety and Clinical Utility of Garenoxacin Mesylate in Patients with Community Acquired Respiratory Tract Infections
ABSTRACT Introduction: Respiratory Tract Infections (RTIs) have become increasingly difficult to treat owing to the increase in resistant Gram positive and Gram negative bacteria. Garenoxacin mesylate, a novel synthetic...
Effect of Mechanical and Chemical Root Surface Treatment on the Shear Bond Strength of Intracanal Post in Primary Anterior Teeth: An In vitro Study
Introduction: Aesthetic restoration of severely mutilated primary anterior teeth still remains as a special challenge to paediatric dentist. Due to increased parent’s concern for aesthetic rehabilitation for their childr...
Comparative Evaluation of Haemodynamic Response during Induction of General Anaesthesia and Incidence of Myoclonus with Etomidate and Propofol: A Randomised Controlled Trial
ABSTRACT Introduction: An ideal induction agent for general anaesthesia should maintain haemodynamic stability, have minimal respiratory side effects, has rapid clearance and minimal drug interaction. Sudden hypotension...