Pressor responses following insertion of laryngeal mask airway in patients with controlled hypertension: comparison with tracheal intubation

Dipasri Bhattacharya, Sharmila Ghosh, Tamonas Chaudhuri, Sudev Saha
Journal of the Indian Medical Association 2008, 106 (12): 787-8, 790, 810
The present study was undertaken in patients with controlled hypertension to determine the pressor responses following insertion of laryngeal mask airway (LMA) as compared to endotracheal intubation. Two hundred patients with controlled hypertension of either sex, belonging to ASA II undergoing elective surgical procedures of 11/2 to 2 hours duration, were studied in a randomised manner into two equal groups: A(n =100) and B(n = 100) depending on whether LMA or endotracheal tube was used. General anaesthesia and controlled ventilation was undertaken according to standard procedure. Baseline and preinsertion values of heart rate, systolic blood pressure, and diastolic blood pressure were recorded and repeated at 1, 2 and 3 minutes after insertion of LMA or endotracheal intubation. The results showed that increase in systolic and diastolic blood pressure following endotracheal intubation (group A) was much more as compared to LMA (group B) (p<0.01). Heart rate also increased from baseline value in endotracheal intubation group than in LMA (P<0.05). To conclude insertion of LMA was associated with lesser pressure response as compared to endotracheal intubation in patients with controlled hypertension. It is an effective method to avoid laryngoscopic pressor response during endotracheal intubation in hypertensive patients.

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