Hemodynamic Changes to Insertion of Various Airway Devices: A Comparative Study

Abstract

Introduction: Cuffed endotracheal tubes (ETTs) are the gold standard for airway management during laparoscopic surgeries but are associated with hemodynamic stress and postoperative throat complications. Supraglottic devices like Proseal LMA (PLMA) and Laryngeal Tube Suction II (LTS II) offer better glottic sealing with fewer complications. This study compares the hemodynamic effects and postoperative outcomes of PLMA, LTS II, and ETT in patients under general anesthesia.

Methods: In this comparative cross-sectional study, 90 ASA I–II patients aged 18–65 years undergoing elective laparoscopic cholecystectomy were assigned to PLMA, LTS II, or ETT groups. Following standard anesthesia induction, airway devices were inserted, and hemodynamic parameters (HR, SBP, DBP, MAP) were recorded at defined intervals.

Results: A total of ninety patients with similar demographic characteristics were assessed. The time taken for insertion was the shortest with endotracheal tube (ETT) at 14.4 ± 2.4 seconds, compared to the laryngeal mask airway (PLMA) at 19.4 ± 4.1 seconds and the LTS II at 21.8 ± 3.1 seconds (p < 0.001). After insertion, ETT resulted in a significantly higher increase in heart rate and blood pressure compared to PLMA and LTS II (p < 0.001), which displayed similar and lower levels of response. The incidence of postoperative sore throat was highest with ETT at 60%, as opposed to PLMA at 26.7% and LTS II at 33.3% (p = 0.02). Statistically non-significant dysphagia occurred more often with ETT (16.7%).

Conclusions: PLMA and LTS II are effective alternatives to ETT for elective surgeries, offering greater hemodynamic stability and reduced postoperative throat morbidity.