Haemodynamic Effects of LMA Fastrach versus Macintosh Laryngoscope While Intubation in Patients Undergoing Cabg
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 9
Abstract
Coronary artery bypass grafting (CABG) surgery is still the predominant operative procedure for myocardial revascularization. The pressor response to intubation is a detrimental factor in these patients, where stable hemodynamics is desired. Use of various intubation aids, is one of the methods by which this could be minimised. Hence, we decided to compare the haemodynamic changes to endotracheal intubation after conventional laryngoscopy versus the use of intubating laryngeal mask airway. We also aimed at comparing the ease of intubation and the complications of the above two intubation methods. Methods: Prospective, randomized, double blinded study in 60 patients between 30-75 yrs age group of either gender, scheduled for elective CABG surgery. patients were evaluated preoperatively and were randomly allocated into group I & group II consisting of 30 patients each using computer generated numbers. General anaesthesia administered and for patients in group I ILMA was used and in group II conventional laryngoscopy and endotracheal intubation was done. Haemodynamic parameters (blood pressure, heart rate, ST segment analysis)were recorded at different time intervals and the occurrence of adverse events such as oxygen desaturation and soft tissue trauma was also noted. Results: The time taken for intubation (represented as Mean SD) was found to be 108.5 (± 36.8) seconds in group I, 22.5 (±11.7) seconds in group II with a p value of 0.0001. There was no statistically significant changes in the haemodynamic parameters (heart rate, blood pressure, ST segment changes) between both the groups. However, statistically significant intragroup comparisons were found. The incidence of intraoperative complications was found to be 6.6% in group I and 3.3% in group II. Thus we concluded that, intubation through intubating laryngeal mask airway takes more time than conventional laryngoscopy and endotracheal intubation but offers no advantage when stress response to intubation is concerned in patients undergoing CABG.
Authors and Affiliations
Vanita .
Keywords
Related Articles
- EP ID EP539325
- DOI 10.21088/ijaa.2349.8471.5918.22
- Views 91
- Downloads 0
Prevention of Hypotension Following Subarachnoid Block; Efficacy of Preloading with Hydroxyethyl Starch Versus Ringer’s Lactate Solution
Background: Arterial hypotension is a potential hazard associated with spinal anesthesia. Routinely, crystalloids and colloids are used for managing hypotension. While crystalloids easily move out of the intravascular sp...
Prospective Study to Evaluate the Role of Vasopressin in Hypernatremia Treatment in Brain Dead Patients
Brain dead patients are potential organ donors but the pathological changes associated with braindeath can affect graft survival. Among various effects of braindeath endocrine and autonomic changes are noteworthy. Centra...
Clinical Study on Complications of Ketamine
Intrathecally administered ketamine is advantageous as its beneficial effects on the cardiovascular system and respiratory functions may be combined with the analgesic effects of spinal anesthesia. The primary mechanism...
Comparative Evaluation of Dexmedetomidine and Fentanyl as Adjuvant to Propofol on Intubation Conditions during Fiberoptic Intubation
Fiberoptic intubation (FOI) is recommended for patients with anticipated difficult airway, failed intubation, unstable cervical spine injurywhere optimum positioning for laryngoscopy is difficult to achieve. Fentany l, a...
Efficacy of Laryngoscopy and Haemodynamic Response to Endotracheal Intubation: A Comparitive Study between Airtraq Optical Laryngoscope and Macintosh Laryngoscope
Background: Laryngoscopy and endotracheal intubation plays a crucial role in administering general anaesthesia. Laryngoscopes ranging from simple rigid scope with light bulb to complex...