Introduction

Laryngoscopy and intubation is known to cause exaggerated stress response leading to hemodynamic changes and metabolic alterations. The stress response cause changes in serum levels of cortisol, glucose and lactate.

Various studies have compared hemodynamic response to tracheal intubation via Intubating Laryngeal Mask Airway (ILMA) versus direct laryngoscopy. We however  compared metabolic parameters for stress response in terms of change in serum glucose, lactate and cortisol values before and after intubation with macintosh laryngoscope vs through Intubating LMA.

Material and Methods:

The present randomized prospective study was carried out in our institute and after taking informed written consent on 70 ASA grade I/II patients aged 18–60 years of either sex, undergoing elective surgeries under general anesthesia. All patients were randomly allocated to two groups . Patients of Group I were intubated by intubating laryngeal mask airway, patients of Group M were intubated with Macintosh laryngoscope

A baseline ABG sample was taken before induction of anesthesia and then after intubation for comparison of glucose, and lactate levels. Similarly, baseline level of serum cortisol were done a day before surgery and then after intubation another blood sample sent for serum cortisol estimation.

Results:

The statistical significant difference was found for mean post procedure serum cortisol values between IMA group and ET group (11.77±3.99 vs 15.36±5.13, p < 0.05). When we compared the change in levels of serum cortisol, glucose and lactate in both the groups we found that there was significant rise in serum cortisol, glucose and lactate after endotracheal intubation as compared to intubation through Intubating LMA

 Conclusion

We  concluded  that ILMA is a safer alternative to direct laryngoscopy for intubation with less stress response in terms of change in metabolic parameters.