title: Insertion of laryngeal mask airway does not increase the intraocular pressure in children with glaucoma.
abstract: OBJECTIVE
  It is hypothesized that in children with glaucoma, the insertion of laryngeal mask airway (LMA) will cause lesser rise in intraocular pressure (IOP) than tracheal tube (TT).
  
  
  OBJECTIVE
  To compare the IOP response to LMA and TT insertion in children with glaucoma.
  
  
  METHODS
  A prospective, randomized, single-blind study was conducted in 30 glaucomatous ASA-1 children, aged 1-10 years scheduled to undergo trabeculectomy. Anesthesia was induced with halothane and maintained for 5 min with 1 MAC of halothane after administering atracurium 0.5 mg·kg(-1) following which LMA or TT was introduced. IOP was measured in both the eyes before and after insertion of airway device for 5 min.
  
  
  RESULTS
  The IOP increased significantly from 27.3 ± 5.2 to 31.2 ± 5.4 mmHg (P < 0.001) after tracheal intubation but returned to baseline within 5 min. The IOP did not change from the baseline after insertion of LMA. The IOP was significantly higher in group TT compared to group LMA at 2 min (P = 0.004) and 5 min (P = 0.01) after the device insertion. The heart rate (HR) increased significantly after tracheal intubation and returned to baseline 4 min after intubation. The HR increase was significantly more in TT group compared to LMA group at all times of observation. Both systolic blood pressure (SBP; P = 0.01) and diastolic blood pressure (DBP; P = 0.02) showed an increase at 1 min in children in group TT.
  
  
  CONCLUSIONS
  Insertion of LMA in glaucomatous children is not associated with an increased IOP response or cardiovascular changes.
authors.affiliation: Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India. neerja.bhardwaj@gmail.com
authors.forename: Neerja
authors.initials: N
authors.lastname: Bhardwaj
authors.forename: Sandhya
authors.initials: S
authors.lastname: Yaddanapudi
authors.forename: Swati
authors.initials: S
authors.lastname: Singh
authors.forename: Surinder S
authors.initials: SS
authors.lastname: Pandav
mesh_terms: D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D005901:Glaucoma / Q000503:physiopathology*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007223:Infant; D007429:Intraocular Pressure / Q000502:physiology*; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks / Q000009:adverse effects*; D008297:Male; D011446:Prospective Studies; D014130:Trabeculectomy