A study to compare the changes in the pressure in the eye, blood pressure and heart rate during insertion of tube in the trachea by direct laryngoscopy [ a tube meant for direct visualization of inside of the larynx] versus intubation through ILMA [ a less invasive device].

Not yet recruiting

Lead Sponsor: Department of Anaesthesiology and Critical Care PGIMS UHS Rohtak

Brief Summary: Endotracheal intubation by direct laryngoscopyis the commonest method of securing a definite airway in most of the surgeriesthat are performed under general anaesthesia. However, it is associated withstress responses due to increased sympathetic discharge that causes rise inintraocular pressure and tachycardia along with increase in blood pressure. Temporary rise in heart rate and blood pressure may not be a problem in a healthyindividual but it may have deleterious effects in patients with hypertension, myocardialinsufficiency or cerebrovascular disease. Acute rise in intraocular pressure canbe hazardous in patients with glaucoma and penetrating eye injury where evensmall rise in intraocular pressure may convert critical disc perfusion intodisc ischemia and extrusion of eye ball contents resulting in blindness. To avoid such complications, many attempts have been made to decrease the acutecardiovascular and ocular responses following laryngoscopy and endotrachealintubation. Use of laryngeal mask airway is one such alternative toendotracheal intubation due to its minimal effects on haemodynamics andintraocular pressure.

Recruitment & Eligibility

Inclusion Criteria

American Society of Anesthesiologists (ASA) physical status (I and II) and Mallampati grade 1 and 2.

Exclusion Criteria

refusal to participate in the study chronic or acute lung disease.
anticipated difficult intubation BMI > 35 kgm-2 pregnancy increased risk of aspiration (eg.
GERD / full stomach) â€¢glaucoma or ocular hypertension â€¢external ocular infections.

Primary Outcome Measures

Name	Time	Method
Rise in IOP is lesser in the ILMA group. Hence intubation via ILMA should preferred in patients of glaucoma or open eye injury patients.	Baseline (Premedication room). \| After endotracheal intubation (Group DL â€“ by direct laryngoscopy, Group IL- through ILMA, before removal of the device). \| 2 min. and 5 min. after intubation.

Secondary Outcome Measures

Name	Time	Method
Use of ILMA for intubation is also associated with lesser rise in blood pressure and heart rate compared to that in intubation via laryngoscopy. Hence, it should be preferred in patients at risk of myocardial ischemia or stroke.	Baseline

Locations (1): PGIMS UHS Rohtak
🇮🇳
Rohtak, HARYANA, India
PGIMS UHS Rohtak
🇮🇳Rohtak, HARYANA, India
Dr Kirti Kshetrapal
Principal investigator
9215650615
kamalkirti47@gmail.com