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 84
- Downloads 0
Comparison of Intrathecal Fentanyl and Midazolam as an Adjuvants to Hyperbaric Bupivacaine in Parturients undergoing Elective Cesarean Sections
Aims: The aim of this study was to evaluate and compare the efficacy and safety of fentanyl and midazolam given intrathecally with hyperbaric 0.5% bupivacaine in patients undergoing elective caesarean sections. Materials...
A Comparative Study to Evaluate Efficacy of Two Doses of Intrathecal Clonidine (15mcg Versus 30mcg) as an Adjuvant to Bupivacaine for Prolongation of Spinal Anaesthesia
Clonidine, an a2-agonist, has been used intrathecally as an adjuvant to bupivacaine in spinal anaesthesia, for prolonging anaesthesia and postoperative analgesia. This study was designed to compare efficacy of two doses...
Sevoflurane Induction of Anaesthesia in Critically ill Patients Undergoing Emergency Laparotomy
Sevoflurane has characteristics of rapid inhalational induction of anaesthesia in 60 secs while maintaining spontaneous respiration, bronchodilatation, haemodynamic stability with rapid recovery in elective scenario. Thi...
A comparative Clinical Study of Subarachnoid Block With 0.75% Isobaric Ropivacaine 15 mg & 0.5% Hyperbaric Bupivacaine 8 mg Patients for Caesarean Section
Background: Ropivacaine is a local anaesthetic agent which is a long acting amide, a pure S (-) enantiomer of propivacaine. It has reduced potential for neuro and cardiotoxicity and safer than bupivacaine. This drug is l...
A Comparative Study of Effect of Short-term Sedation of Post-operative Mechanically Ventilated Patients with Dexmedetomedine and Propofol
Background and Objectives: Post-operative mechanically ventilated patient in the intensive care unit (ICU) frequently need sedation and analgesia to facilitate care. Inadequate Sedation in patients admitted to the ICU af...