Jemds.com Original Research Article J. Evolution Med. Dent. Sci./eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 6/ Issue 17/ Feb. 27, 2017 Page 1313 COMPARISON OF HAEMODYNAMIC CHANGES IN RESPONSE TO ENDOTRACHEAL INTUBATION AND LARYNGEAL MASK AIRWAY IN CONTROLLED HYPERTENSIVE PATIENTS- A RANDOMISED STUDY Vanilla Chopra 1 , Vikas Gupta 2 , Abdul Qayoom Lone 3 , Imtiaz A. Naqash 4 1 Assistant Professor, Department of Anaesthesia and Critical Care, Acharya Shri Chander College of Medical Sciences. 2 Assistant Surgeon, Department of Surgery, Jammu and Kashmir Health Services. 3 Professor, Department of Anaesthesia and Critical Care, Sher-E-Kashmir Institute of Medical Sciences. 4 Professor, Department of Anaesthesia and Critical Care, Sher-E-Kashmir Institute of Medical Sciences. ABSTRACT BACKGROUND Context - Laryngeal Mask Airway (LMA) Classic™ and Endotracheal Tube (ETT) are two devices used for the maintenance of airway. The aim of this study is to compare the haemodynamic responses of endotracheal intubation with that of laryngeal mask airway insertion in controlled hypertensive patients during general anaesthesia. Settings and Design - This study was conducted as randomised observational study in a teaching hospital. MATERIALS AND METHODS We conducted a randomised controlled trial with sixty controlled hypertensive patients undergoing elective surgical procedures of 60 - 90 minutes’ duration under general anaesthesia. Patients were randomly assigned to be either intubated with endotracheal tube (Group I) or laryngeal mask airway (Group II). The following study parameters were noted after insertion: heart rate, blood pressure (systolic, diastolic and mean arterial pressure) and thereafter rate pressure product was calculated. Statistical Analysis Used - Descriptive analyses were expressed as a mean ± standard deviation. Independent t-test was used for parametric data and Chi-square test for non-parametric data. P-value less than 0.05 (p < 0.05) was taken to be statistically significant. RESULTS All the three study parameters, i.e. heart rate, blood pressure and rate pressure product showed a significant elevation compared to baseline in both groups. However, while comparing two groups the elevation was significantly higher and persisted for longer duration after endotracheal intubation as compared to placement of laryngeal mask airway. CONCLUSION Use of LMA Classic TM during general anaesthesia, unless contraindicated, is a better option to attenuate haemodynamic responses to laryngoscopy and endotracheal intubation, particularly in situations where such changes are highly undesirable, i.e. hypertensive patients. KEYWORDS Endotracheal Intubation, Laryngeal Mask Airway, Haemodynamics. HOW TO CITE THIS ARTICLE: Chopra V, Gupta V, Lone AQ, et al. Comparison of haemodynamic changes in response to endotracheal intubation and laryngeal mask airway in controlled hypertensive patients- a randomised study. J. Evolution Med. Dent. Sci. 2017;6(17):1313-1316, DOI: 10.14260/Jemds/2017/285 BACKGROUND Endotracheal Intubation (ETI) has facilitated efficient delivery of anaesthetic gases into the trachea besides proper control of airway and ventilation during intraoperative period. However, this procedure is associated with a sympathetic adrenergic pressor response leading to tachycardia and increase in systemic arterial pressure. 1 This is also reflected as excessive rise in plasma catecholamine levels. 2 The majority of these stimuli arise from the stimulation of the supraglottic region by tissue tension induced by laryngoscopy. Placement of Endotracheal Tube (ETT) and inflation of the cuff in the subglottic region produces a smaller additional response. 3 Financial or Other, Competing Interest: None. Submission 06-02-2017, Peer Review 19-02-2017, Acceptance 21-02-2017, Published 27-02-2017. Corresponding Author: Vanilla Chopra, 49, 1-A, Trikuta Nagar, Jammu. E-mail: vanillachopra@yahoo.co.in DOI: 10.14260/jemds/2017/285 Complications of the pressor response following laryngoscopy may include myocardial ischaemia, 4 increase in intracranial pressure, intracranial haemorrhage and cardiac failure. 5 These complications are serious enough in normotensive patients, but an exaggerated response has been reported in hypertensive patients, 6 whether treated beforehand or not. In particular, surgical patients with Ischaemic Heart Disease (IHD) or Hypertension (HT) or both have been shown to carry an increased risk of perioperative complications. 7 Attempts are made to attenuate this response with a variety of pharmacological manoeuvres and introduction of Laryngeal Mask Airway (LMA) Classic TM has made a step forward in this regard. LMA is a device that bridges the gap in airway management between tracheal intubation and conventional face mask. Insertion of LMA does not require laryngoscopy, although introduction of the device and inflation of the cuff may exert pressure on the anterior pharyngeal wall. However, lack of direct laryngeal trauma