DOI: 10.36347/sjams.2014.v02i06.126

Pages: 3475-3480

Introduction: Endotracheal Intubation (ETI) is gold standard for airway management. Proseal Laryngeal Mask Airway (PLMA) insertion using Gum Elastic Bougie (GEB) guidance, which has got 100% first attempt success rate, also requires laryngoscopy, hence nullifying its advantage of being a supraglottic airway device. We aimed to compare the haemodynamic responses associated with laryngoscopy assisted GEB guided PLMA placement with that of conventional endotracheal intubation. Method: Hundred normotensive ASA1 or 2 patients of either sex (age 18 to 40yrs) undergoing general anesthesia for elective surgery included and evaluated for pressor response. Following a uniform premedication and standard anesthesia technique (thiopentone + vecuronium), either of airway was placed and Heart rate, HR (beats/min); Mean blood pressure, MAP (mmHg) (at Tb =base line, T0=just before laryngoscopy and PLMA/ETT placement, T1 =1min, T3= 3min, T5 =5 min, T7 =7 min after placement). Results: Patients demographics between the PLMA and ETT groups were similar. Following laryngoscopy and PLMA\ETT placement, both were associated with statistically significant increase in HR and MAP with respect to its basal value. Although it was less marked in case of PLMA group, when comparison was made within individual group. Duration of laryngoscopy and time of placement were longer in PLMA group as compared to ETT group (35.71 and 12.69 sec. vs 21.30 and 10.76 sec. respectively). ETT insertion was associated with higher incidence of cough (p<0.05),but similar for sore throat and hoarseness(p>0.05).