Cardiovascular changes with the laryngeal mask airway in cardiac anaesthesia.
BACKGROUND
The laryngeal mask airway (LMA) causes fewer haemodynamic changes, particularly in mean arterial pressure (MAP) and heart rate (HR), than tracheal intubation using either laryngoscopy or the intubating LMA. There are no data for patients with coronary artery disease.


METHODS
We studied 27 patients having coronary artery bypass grafting, prospectively randomized to be managed with either the LMA or tracheal intubation using either laryngoscopy or the ILMA. We used invasive monitoring to compare the haemodynamic effects in each group during induction and emergence from anaesthesia.


RESULTS
Both methods of intubation caused an increase in MAP compared with the LMA (P<0.05). Mixed venous oxygen saturation increased in the intubated patients but not with the LMA (P<0.05). HR did not change at induction in the LMA group. Changes at extubation were similar in all groups but cardiac index was lower in the LMA group (P<0.05).


CONCLUSIONS
The LMA allows airway management without hypertension and tachycardia and should be considered when anaesthetizing patients with coronary disease.
Bennett
S R
SR
Department of Anaesthesia, Castle Hill Hospital, Hull HU16 5JQ, UK. sean@kemproad.freeserve.co.uk
Grace
D
D
Griffin
S C
SC
D000769:Anesthesia, Inhalation; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D007432:Intraoperative Period; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D007828:Laryngoscopy; D016343:Monitoring, Intraoperative; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies
D010100:Oxygen