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FRONTIERS IN MEDICAL CASE REPORTS - Volume 4; Issue 1, (Jan-Feb, 2023)

Pages: 1-11

Comparison of the Hemodynamic Effects of Intubation via Fastrach Laryngeal Mask Airway with Standard Direct Laryngoscopy in Hypertensive Patients

Gökhan Göktan, Ayse Ülgey

Category: Medical Case Reports

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Background/Aim: In this study, hemodynamic response and postoperative complications of intubation via laryngoscopy compared to laryngeal mask airway were investigated in hypertensive patients.

Materials and Methods: Following ethics committee approval, 120 ASA II-III patients (aged 18-65 years) with stage 1 or 2 hypertension who required endotracheal intubation in an elective surgery were randomly assigned into 2 groups. Group L (n = 60) was defined as the direct laryngoscopy in endotracheal intubation group, and Group F (n = 60) used the Fastrach LMA in endotracheal intubation. The HR, SAP, DAP, MAP and SpO2 were recorded at baseline (after premedication by midazolam), after anesthesia induction (when no response was recorded to TOF stimulation), during intubation, and on minutes 0, 1, 2, 3, 4 and 5 after intubation. The patients were transferred to the recovery room after extubation. Patients were asked at the postoperative 30th minute whether they experienced a sore throat or hoarseness. To check pharyngolaryngeal morbidity, sore throat and hoarseness were assessed by a 4-point scale.

Results: Demographic characteristics were found to be similar in both groups. Thyromental and sternomental distance and difficulties in mask ventilation were found to be similar. It was found that time to intubation was significantly higher in group F. In group L, the HR, DAP and MAP values increased on minute 0 after intubation when compared to the baseline values and returned to baseline values within one minute. In group F, the HR, SAP, DAP and MAP decreased on minute 0 compared to the baseline. Postoperative morbidity was comparable between the groups. No significant difference was found in sore throat and hoarseness between the groups.

Conclusion: Intubation via LMA is more advantageous in alleviating hemodynamic responses. Intubation via direct laryngoscopy is a more rapid method when compared to intubation via LMA. There was no significant difference in upper respiratory tract morbidity between the groups.

Keywords: Intubation, Hypertension, LMA, Larengeal Mask, Arterial Pressure


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