Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Prax, N.
A comparative study of stress responses, efficacy and complications of Intubating Laryngeal Mask Airway, Lryngeal Tube-Suction and ProSseal Laryngeal Mask Airway
[ Dissertation ] Graz Medical University ; 2004. pp.70.
- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Metzler Helfried
- Altmetrics:
- Abstract:
- The aim of my study was to compare the hemodynamic and catecholamine stress responses, adequacy of ventilation, as well as complications of the Intubating Laryngeal Mask Airway (ILMA), the ProSeal Laryngeal Mask Airway (PLMA) and the Laryngeal Tube-Suction (LTS) in a prospective, randomized, controlled study. Fifty-three patients undergoing general surgery were randomly allocated to be ventilated via one of the three airway devices. All three devices could be inserted easily and rapidly, providing adequate ventilation and oxygenation in most of the study patients. Mean arterial pressure (MAP) significantly increase with the insertion/intubation via the ILMA from 698 mmHg to 8418mmHg (p=0.0029). Whereas MAP did not significantly change with the insertion of the PLMA (from 6610 to 7112mmHg, p=0.1008) or with the insertion of the LTS (from 699 to 7516mmHg, p=0.186). There was no significant difference between the MAP following the insertion of the PLMA of the LTS (p=0.152). However, with the extubaton of the ILMAs endotracheal tube, or with the removal of the PLMA or LTS, MAP significantly increased from 748, 8218, 749mmHg to 9714, 10119, 9416 mmHg respectively with no difference between the three groups (p=0.7331). The mean norepinephrine plasma concentrations significantly increased with the insertion/intubation via the ILMA and the insertion of PLMA and LTS from 88.926.5, 13670.1, 84.427.5 pg/ml to 135.738.6, 158.474.9, 112.733.5 pg/ml respectively with no difference between the three groups (p=0.058). Whereas epinephrine only significantly increased with intubation in the ILMA group from 18.58.1 to 35.912.3 pg/ml (p=0.001) and with the insertion of the LTS from 15.56.4 to 26.77.5 pg/ml (p=0.0001) and did not change with the insertion of the PLMA (from 18.410.2 to 22.714.3 pg/ml, p=0.0898). Implication: I conclude that the insertion/intubation via the ILMA causes a pronounced stress response in spite of achiving intubation though the ILMA easily and rapidly and providing adequate ventilation and maintenance of the airway. In this study I showed that the hemodynamic and catecholamine stress responses after insertion of the Intubating Laryngeal Mask Airway were significantly higher compared with the Laryngeal Tube-S or ProSeal Laryngeal Mask Airway. The LTS as well as the PLMA are useful devices in the management of the airway.