Comparison of Hemodynamic Changes After the Insertion of Laryngeal Mask Airway Versus Endotracheal Intubation | Chapter 5 | Medicine and Medical Research: New Perspectives Vol. 10

Background and Aims: Serious hemodynamic deviations can arise with endotracheal intubation, which leads to a short but evident Cardiovascular response. The aim of this study is to observe the hemodynamic responses after the insertion of laryngeal mask airway and endotracheal intubation.

Study Design:  This is a randomised controlled study.

Place and Duration of Study: The study was organized at SRM Medical College and Research Center, Kattangulathur, 603203, India over the course of one year.

Methodology: Sixty patients, varying in age between eighteen to sixty, were divided into two comparable groups at random: 30 belonged to Group 1 (LMA) and 30 to Group 2 (ETT). Heart rate (HR), blood pressure (SBP & DBP), and oxygen saturation were measured at baseline, during induction, and at the 0th, 3rd, and 5th min following successful intubation in each group in order to evaluate the hemodynamic response.

Results: Patients in both groups had stable vitals. The mean HR, DBP, SBP and oxygen saturation between the Group LMA and Group ETT were analyzed. After statistical analysis with an independent student t-test was found to be statistically significant (p < 0.05) for mean HR, SBP and DBP whereas mean oxygen saturation was found to be statistically insignificant (p >0.05).

Conclusion: The study concludes that the laryngeal mask airway for short (<60 mins) surgical procedures causes less hemodynamic changes when compared with endotracheal intubation.

 

Author (s) Details

A. Pushparani
Department of Anaesthesiology, SRM medical college and research center, SRMIST, Kattangulathur, 603203, India.

 

G. Mirunalini
Department of Anaesthesiology, SRM medical college and research center, SRMIST, Kattangulathur, 603203, India.

 

Getsyal
Department of Anaesthesiology, SRM medical college and research center, SRMIST, Kattangulathur, 603203, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v10/2298

Simple, Reliable, and Safe Technique for Endotracheal Tube Cuff Inflation: A Comparative Evaluation of the Three Common Methods | Chapter 11 | Medical Research and Its Applications Vol. 3

 

The aim of this study is to compare the three common (Sealing pressure, precise standard pressure or finger estimation) regarding the effective tracheal seal and the incidence of post-intubation airway complications. Tracheal arterial capillary pressure decreases when the cuff exerts pressure greater than 30 cm H2O, causing tracheal ischemia proportional to the pressure exerted by the cuff and to the duration of exposure. There is a strong relationship between endotracheal cuff pressure and airway complication, therefore, the methods of endotracheal tube cuff inflation are of great importance to maintaining safe and effective cuff pressure. Seventy-five adult patients scheduled for N2O-free general anesthesia were enrolled in this study. After induction of anesthesia, endotracheal tubes size 7.5 mm for females and 8.0 mm for males were used. Patients were randomly assigned into one of three groups. Control group (n=25), the cuff was inflated to a pressure of 25 cm H2O, sealing group (n=25), the cuff was inflated to prevent air leaks at an airway pressure of 20 cm H2O and finger group (n=25), the cuff was inflated using finger estimation. Tracheal leaks, the incidence of sore throat, hoarseness and dysphagia were tested.  Although cuff pressure was significantly low in the sealing group compared to the control group (P<0.001), the incidence of sore throat was similar in both groups. On the other hand, cuff pressure as well as the incidence of sore throat was significantly higher in the finger group compared to both the control and the sealing group (P<0.001 and P=0.008). The incidence of dysphagia and hoarseness were similar in the three groups. None of the patients in the three groups developed air leaks around the endotracheal tube cuff. The incidence of sore throat was significantly higher in the finger group compared to both the sealing and control groups, whereas the incidence of both hoarseness and dysphagia was similar in the three groups.

Conclusions: When it comes to efficient sealing and a low rate of sore throat, sealing cuff pressure in N2O-free anesthesia is a simple, undemanding, and safe substitute for the conventional method.

 

Author(s)details:-

 

Roshdi R. Al-Metwalli|
Department of Anesthesia, Imam Abdulrahman Bin Faisal University [Dammam University (Previously)], Saudi Arabia.

 

Abdulmohsen A. Al-Ghamdi
Department of Anesthesia, Imam Abdulrahman Bin Faisal University [Dammam University (Previously)], Saudi Arabia.

 

Hany A. Mowafi
Department of Anesthesia, Imam Abdulrahman Bin Faisal University [Dammam University (Previously)], Saudi Arabia.

Sayed Sadek
Department of Anesthesia, Imam Abdulrahman Bin Faisal University [Dammam University (Previously)], Saudi Arabia.

 

Wesam F. Mousa
Qatif Central Hospital, Saudi Arabia.

 

Please See the book here :-  https://doi.org/10.9734/bpi/mria/v3/230