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Intraocular pressure and haemodynamic responses to insertion of the i-gel, laryngeal mask airway or endotracheal tube.
Eur J Anaesthesiol. 2011 Jun; 28(6):443-8.EJ

Abstract

CONTEXT

We hypothesised that the effects of insertion of an i-gel supraglottic airway management device on intraocular pressure (IOP) and haemodynamic variables would be milder than those associated with insertion of a laryngeal mask airway (LMA) or an endotracheal tube.

OBJECTIVES

This study evaluated IOP and haemodynamic responses following insertion of an i-gel airway, LMA or endotracheal tube.

DESIGN AND SETTING

This was a randomised controlled study in a tertiary care centre in which 60 adults scheduled for elective non-ophthalmic procedures under general anaesthesia were allocated to one of three groups. Patients with pre-existing glaucoma, cardiovascular, pulmonary or metabolic diseases or anticipated difficult intubation were excluded.

INTERVENTIONS

Following induction of general anaesthesia, an endotracheal tube, LMA or i-gel device was inserted.

MAIN OUTCOME MEASURES

IOP, SBP, DBP, heart rate (HR) and perfusion index were measured before induction of anaesthesia and before and after insertion of the airway device.

RESULTS

Insertion of the i-gel did not increase IOP. Insertion of an endotracheal tube increased IOP from 11.6 ± 1.6 to 16.5 ± 1.7 mmHg (P < 0.001). The post-insertion IOP exceeded the pre-induction value (P < 0.05). Insertion of the LMA increased IOP from 13.0 ± 1.5 to 14.7 ± 1.8 mmHg (P < 0.01), but this did not exceed the pre-induction value. Tracheal intubation significantly increased HR, SBP and DBP. Insertion of the LMA significantly increased HR and SBP. These increases were significantly higher than those which followed insertion of the i-gel device. Insertion of the endotracheal tube or LMA resulted in a significant decrease in perfusion index which was maintained for 5 min following tracheal intubation and for 2 min after insertion of the LMA. Insertion of the i-gel device did not change perfusion index significantly.

CONCLUSION

Insertion of the i-gel device provides better stability of IOP and the haemodynamic system compared with insertion of an endotracheal tube or LMA in patients undergoing elective non-ophthalmic surgery.

Authors+Show Affiliations

Department of Anaesthesia, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21455075

Citation

Ismail, Salah A., et al. "Intraocular Pressure and Haemodynamic Responses to Insertion of the I-gel, Laryngeal Mask Airway or Endotracheal Tube." European Journal of Anaesthesiology, vol. 28, no. 6, 2011, pp. 443-8.
Ismail SA, Bisher NA, Kandil HW, et al. Intraocular pressure and haemodynamic responses to insertion of the i-gel, laryngeal mask airway or endotracheal tube. Eur J Anaesthesiol. 2011;28(6):443-8.
Ismail, S. A., Bisher, N. A., Kandil, H. W., Mowafi, H. A., & Atawia, H. A. (2011). Intraocular pressure and haemodynamic responses to insertion of the i-gel, laryngeal mask airway or endotracheal tube. European Journal of Anaesthesiology, 28(6), 443-8. https://doi.org/10.1097/EJA.0b013e328345a413
Ismail SA, et al. Intraocular Pressure and Haemodynamic Responses to Insertion of the I-gel, Laryngeal Mask Airway or Endotracheal Tube. Eur J Anaesthesiol. 2011;28(6):443-8. PubMed PMID: 21455075.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intraocular pressure and haemodynamic responses to insertion of the i-gel, laryngeal mask airway or endotracheal tube. AU - Ismail,Salah A, AU - Bisher,Neama A, AU - Kandil,Hazem W, AU - Mowafi,Hany A, AU - Atawia,Hayam A, PY - 2011/4/2/entrez PY - 2011/4/2/pubmed PY - 2012/4/14/medline SP - 443 EP - 8 JF - European journal of anaesthesiology JO - Eur J Anaesthesiol VL - 28 IS - 6 N2 - CONTEXT: We hypothesised that the effects of insertion of an i-gel supraglottic airway management device on intraocular pressure (IOP) and haemodynamic variables would be milder than those associated with insertion of a laryngeal mask airway (LMA) or an endotracheal tube. OBJECTIVES: This study evaluated IOP and haemodynamic responses following insertion of an i-gel airway, LMA or endotracheal tube. DESIGN AND SETTING: This was a randomised controlled study in a tertiary care centre in which 60 adults scheduled for elective non-ophthalmic procedures under general anaesthesia were allocated to one of three groups. Patients with pre-existing glaucoma, cardiovascular, pulmonary or metabolic diseases or anticipated difficult intubation were excluded. INTERVENTIONS: Following induction of general anaesthesia, an endotracheal tube, LMA or i-gel device was inserted. MAIN OUTCOME MEASURES: IOP, SBP, DBP, heart rate (HR) and perfusion index were measured before induction of anaesthesia and before and after insertion of the airway device. RESULTS: Insertion of the i-gel did not increase IOP. Insertion of an endotracheal tube increased IOP from 11.6 ± 1.6 to 16.5 ± 1.7 mmHg (P < 0.001). The post-insertion IOP exceeded the pre-induction value (P < 0.05). Insertion of the LMA increased IOP from 13.0 ± 1.5 to 14.7 ± 1.8 mmHg (P < 0.01), but this did not exceed the pre-induction value. Tracheal intubation significantly increased HR, SBP and DBP. Insertion of the LMA significantly increased HR and SBP. These increases were significantly higher than those which followed insertion of the i-gel device. Insertion of the endotracheal tube or LMA resulted in a significant decrease in perfusion index which was maintained for 5 min following tracheal intubation and for 2 min after insertion of the LMA. Insertion of the i-gel device did not change perfusion index significantly. CONCLUSION: Insertion of the i-gel device provides better stability of IOP and the haemodynamic system compared with insertion of an endotracheal tube or LMA in patients undergoing elective non-ophthalmic surgery. SN - 1365-2346 UR - https://www.unboundmedicine.com/medline/citation/21455075/Intraocular_pressure_and_haemodynamic_responses_to_insertion_of_the_i_gel_laryngeal_mask_airway_or_endotracheal_tube_ L2 - https://doi.org/10.1097/EJA.0b013e328345a413 DB - PRIME DP - Unbound Medicine ER -