Comparative study between laryngeal mask airway and endotracheal tube as regard the effect on intraocular pressure and hemodynamic response in pediatrics undergoing congenital glaucoma surgery
Omar, S., Abdelrahman, A., Abd-elgalil, W., Mohamed, K. (2017). Comparative study between laryngeal mask airway and endotracheal tube as regard the effect on intraocular pressure and hemodynamic response in pediatrics undergoing congenital glaucoma surgery. EKB Journal Management System, 21(3), 543-552. doi: 10.21608/smj.2017.55001
Sabah Ahmed Omar; Abdelrahman Hassan Abdelrahman; Wesam Abd-elgalil; Khald Mohamed. "Comparative study between laryngeal mask airway and endotracheal tube as regard the effect on intraocular pressure and hemodynamic response in pediatrics undergoing congenital glaucoma surgery". EKB Journal Management System, 21, 3, 2017, 543-552. doi: 10.21608/smj.2017.55001
Omar, S., Abdelrahman, A., Abd-elgalil, W., Mohamed, K. (2017). 'Comparative study between laryngeal mask airway and endotracheal tube as regard the effect on intraocular pressure and hemodynamic response in pediatrics undergoing congenital glaucoma surgery', EKB Journal Management System, 21(3), pp. 543-552. doi: 10.21608/smj.2017.55001
Omar, S., Abdelrahman, A., Abd-elgalil, W., Mohamed, K. Comparative study between laryngeal mask airway and endotracheal tube as regard the effect on intraocular pressure and hemodynamic response in pediatrics undergoing congenital glaucoma surgery. EKB Journal Management System, 2017; 21(3): 543-552. doi: 10.21608/smj.2017.55001

Comparative study between laryngeal mask airway and endotracheal tube as regard the effect on intraocular pressure and hemodynamic response in pediatrics undergoing congenital glaucoma surgery

Sohag Medical Journal
Article 66, Volume 21, Issue 3, October 2017, Page 543-552  XML PDF (124 K)
Document Type: Original Article
DOI: 10.21608/smj.2017.55001
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Authors
Sabah Ahmed Omar1; Abdelrahman Hassan Abdelrahman2; Wesam Abd-elgalil1; Khald Mohamed1
1Department of anesthesia and ICU, Sohage University, sohage, Egypt
2Department, of Anesthesia & Intensive Care, Fuculty of Medicine, Sohag University.
Abstract
Background:This study aims to compare both endotracheal (ETT) tube and laryngeal mask airway (LMA) as a conduit for continuous ventilation during general anaesthesia as regard their effect on the hemodynamic response and intraocular pressure (IOP) after their insertion intra operative in pediatric patients undergoing congenital glaucoma surgery.
Methods:Patients were divided into two groups of 25 patients each. Group I; patients who were subjected to LMA insertion group II ;patients who were subjected to conventional laryngoscopy and endotracheal intubation .
Results:The result of our study demonstrated that there was high significant differences between LMA insertion and endotracheal intubation as regard hemodynamic responses; Heart rate increased after insertion of ETT in (group II), HR (p value <0.05) and continued until 2 min after insertion. Also, there was a significant difference in the mean blood pressure after insertion in ETT group (p value <0.05), BP continued to be elevated until 3 min after insertion. As regard IOP in our study, we noted that there was no difference between two group at base line but there was a significant increase in the intraocular pressure after insertion in ETT group when compared with LMA group (p value<0.05), and continued until 3 min after insertion then regressing without significant difference between both groups all over the procedure,  after removal of both devices ,there was increase in IOP measurement in both groups but the increase was insignificantly different between both groups  (p value >0.05) . As regard complications, in our study fewer complications occurred after removal of both devices ; as coughing in two cases (8%) in LMA group compared with six cases (28%) in ETT group, two cases (2%) had straining in LMA group compared with seven cases (28%) in ETT group  ,one case (4%) had laryngospasm in ETT group  with no significant difference between the two groups (p. value>0.05), also we noticed that complications as airways trauma, aspiration and gas leakage didn’t occur.
Conclusion:Laryngeal Mask Airway was better than endotracheal intubation when used as a conduit for airway management; it had less hemodynamic responses and changes in the IOP.
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References
  1. Akhtar TM, McMurray P, Kerr WJ, Kenny GNC. A comparison of laryngeal mask airway with tracheal tube for intraocular ophthalmic surgery. Anaesthesia. 47:668-671, 1992.
  2. Alan R, Aktienhead, David J, Rowbotham, Graham Smith. Text book of anaesthesia 4th ed. Churchill Livingstone. 101-106,423-514,2001.
  3. Ates Duman, Ogün CO, Okesli S. The effect on intraocular pressure of tracheal intubation or laryngeal mask insertion during sevoflurane anaesthesia in children without the use of muscle relaxants.Pediatr Anesth.11:421-4, 2001.
  4. Brain A. L J. The laryngeal   mask new concept in airway management. British   Journal of Anaesthesia. 55: 801-805, 1983.
  5.  Broderick P.M., Webster N.R. and Nunn J.F. The laryngeal mask airway: a study of 100 patients during spontaneous ventilation.Anaesthesia. 44: 238-241, 1989.
  6. Edward Morgan G, Maged S .Mikhael J, Murray.  Clinical Anaesthesiology .4th ed. Lange Medical Books; McGraw-Hill Medical Publishing Division. 97-110,2008.
  7. Forbes AM, Dally FG. Acute hypertension during induction of anaesthesia and endotracheal intubation in man.Br J Anaesth. 42: 618-624, 1970.
  8. Fujii Y, Saitoh Y, Tanaka H, Toyooka H. Cardiovascular responses to tracheal extubation or LMA removal in children. Can J Anesth.45:178-81, 1998.
  9. Gulati M, Mohta M, Ahuja S, Gupta VP. Comparison of laryngeal mask airway with tracheal tube for ophthalmic surgery in paediatric patients. Anaesth Intensive Care.32:383-9, 2004.
  10. Lalwani J, Dubey KP, Sahu BS, Shah PJ. Proseal laryngeal mask airway: An alternative to endotracheal intubation in paediatric patients for short duration surgical procedures. Indian J Aneasth;54:541-5, 2010.
  11. Qazi Ehsan Ali1, Syed Hussain Amir2, Uzma Firdaus3, Abdulla Z Azhar. Journal of Dental and Medical Sciences: Volume 4, Issue 4 (Jan.- Feb. 2013).
  12. Sangeeta Deka, Nilotpal Dasand, Mudasir Ahmad Mir, Ajaz Ahmad Mir. Proseal LMA versus endotracheal tube a clinical comparative study of its different effects in paediatric patients undergoing lower abdominal surgeries. International Journal of Contemporary Medical Research. 3(5):1301-1305, 2016.
  13. Watcha MF, White PF, Tyschen I and Stevens JL. Comparative effects of laryngeal mask airway and endotracheal tube insertion on intraocular pressure in children. Anaesth Analg.75: 355-360, 1992.
  14. Watcha MF, White PF, Tyschen I and Stevens JL. Comparative effects of laryngeal mask airway and endotracheal tube insertion on intraocular pressure in children. Anaesth Analg.75: 355-360, 1992
  15. Wood M.L.B. and Forrest E.T.S. The hemodynamic response to the insertion of the laryngeal mask airway: a comparison of laryngoscopy and tracheal intubation. Acta Anesth. Scand. 38: 570-573, 1994.
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