A Randomized Clinical Trial Comparing the Insertion Conditions and Pressor Responses of Two Airway Devices ‘Combitube’ and ‘Laryngeal Mask Airway’ During Elective Anaesthetic Procedures

Insertion Conditions and Pressor Responses of Two Airway Devices

Abstract

Background: The major responsibility of an anaesthesiologist is management of airway so as to provide adequate ventilation to the patient by securing an unobstructed airway when general anaesthesia is administered. Advanced airway devices like Laryngeal Mask Airway (LMA) and Combitube are now considered as alternatives to endotracheal intubation for securing the airway and providing adequate ventilation even in difficult intubation and emergency situations. Objectives: To determine and compare the insertion conditions and pressor responses of two airway devices combitube and laryngeal mask airway during elective anesthetic procedures. Subjects and Methods: 60 patients of age between 18-55 years, belonging to ASA grade I and II, scheduled for elective surgeries under general anaesthesia were included in the study.Patients with uncontrolled cardiovascular, respiratory, hepatic, renal diseases, morbid obesity, pharyngeal masses, history of chronic obstructive pulmonary diseases, oesophageal pathology were excluded in the study. All patients were allocated randomly by envelope method into two groups of 30 each, Group-L and Group- C.For patients in group L- airway was secured with laryngeal mask airway.Patients in group C- airway was secured with combitube. Results: Insertion conditions were better with LMA when compared to Combitube (P= 0.00325). Mean heart rate of LMA group was less at 1, 2, 3,7 minutes compared to combitube group. Mean systolic blood pressure of LMA group is significantly less at 1, 2, 3, 5, 7, 10, minutes than that of combitube group. Mean diastolic blood pressure of LMA group is significantly less at 1,2, 3 & 5 minutes compared to combitube group. Conclusion: We concluded that the insertion conditions (ease of insertion) were better and the associated pressor responses were less with LMA than with combitube.Based on our conclusions, we can say that LMA is a better alternative device when compared to combitube in maintaining an intact airway. However, both can be safely used to conduct general anaesthesia for elective surgical procedures.