Comparison of armoured laryngeal mask airway with endotracheal tube for adenotonsillectomy.
OBJECTIVE
To assess the reliability of armoured laryngeal mask airway for adenotonsillectomy and to compare the haemodynamic changes during anaesthesia with those of endotracheal tube.


METHODS
A prospective comparative study.


METHODS
Services Hospital Lahore/ Services Institute of Medical Sciences from April to September 2003.


METHODS
A total of 100 patients undergoing adenotonsillectomy between ages 10-35 years and ASA I status were enrolled for the study. Two groups with 50 patients in each group were formed. Group I patients underwent surgery with armoured laryngeal mask airway while group II underwent surgery with endotracheal intubation. Baseline heart rate, systolic blood pressure and diastolic blood pressure were noted pre-operatively, one minute after insertion and every five minutes after induction in both the groups. A change in all these haemodynamic parameters from the baseline was noted. The effect of Boyle Davis Gag and adequacy of surgical access were also noted. Occurrence of cough, laryngospasm and stridor were noted at the time of recovery in both the groups.


RESULTS
Baseline variables in both groups were identical. Surgical access was adequate in 48/50 patients in group I while it was adequate in 49/50 patients in group II. The frequencies of cough, laryngeal spasm and stridor were lower in group I. In group I, there was insignificant change from baseline in heart rate, systolic and diastolic blood pressure at one, five and ten minutes after induction. In group II, significant change from baseline was observed in heart rate (p < 0.01), systolic blood pressure (p < 0.05) and diastolic blood pressure (p < 0.05).


CONCLUSIONS
Armoured laryngeal mask is reliable for performing adenotonsillectomies. It provides adequate surgical access for adenotonsillectomy. It is also associated with lower occurrence of cough, bronchospasm and stridor at recovery. Use of armoured laryngeal mask is associated with fewer haemodynamic changes compared with those of endotracheal tube.
Aziz
Leena
L
Department of Anaesthesiology, Services Institute of Medical Sciences/ Services Hospital, Lahore. drayub@wol.net.pk
Bashir
Khalid
K
D000233:Adenoidectomy; D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D007828:Laryngoscopy; D008297:Male; D014068:Tonsillectomy