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 .
Comparison of Laryngoscopic View Obtained by Conventional 10 cm Head Rise to that Obtained by Horizontal Alignment of External Auditory Meatus and Sternal Notch
Objectives: The aim of this study was to determine the effect of position (Sniff / HELP) during laryngoscopy on the extent of change/ improvement in laryngoscopic view of glottis. Materials and Methods: This prospective,...
Feasibility of Hematoma Block for Closed Reduction of Fractures of Distal End of Radius: A Comparison with General Anesthesia
Fractures of distal radius are common and there are different modes of anesthesia to obtain pain relief prior to closed reduction. The aim of this study was to prospectively compare hematoma block alone and general anest...
Intubation Sans Relaxant: Propofol VS. Triple Nerve Block
Aims: Methods that avoid use of muscle relaxants during intubation help us when their use would be detrimental to the patient/situation. Here we aim at intubations without muscle relaxants which could be of great signifi...
Postoperative Analgesia for Inguinal Hernia Repair: Comparison of Ropivacaine with Bupivacaine
Background and Objectives: Inguinal hernia surgery is one of the commonest day care procedures and have very high incidence of moderate to severe postoperative pain which remains a great challenge for the anesthesiologis...
Intrathecal Bupivacaine with Neostigmine versus Clonidine as an Adjuvants in Lower Abdominal Surgeries
Background: A number of adjuvants to local anesthetics have been used intrathecally to prolong analgesia. So, the present study was planned to study the effect of intrathecal bupivacaine with neostigmine versus clonidine...