Comparison of intraocular pressure and hemodynamic responses to insertion of laryngeal mask airway or endotracheal tube in elective paediatric ophthalmic procedures

Introduction: The main objective of the study was to assess the benefits of using laryngeal mask airway in place of endotracheal intubation in reducing the intraocular pressure and hemodynamic response in paediatric patients posted for elective ophthalmic procedures. This prospective randomized study was conducted over a period of six months in the Regional institute of Ophthalmology. Materials and Methods: Sixty paediatric patients aged between 2-12 years, belonging to ASA grade 1 & 2 and posted for elective ophthalmic procedures were allocated into two groups, each of 30 patients, by a closed envelope method. Laryngeal mask airway (LMA) insertion for group I and Endotracheal intubation (ETI) for group II were performed. Intraocular pressure measurements at Baseline, pre-insertion, at 30th second and at 2nd minutes between the groups were compared. Corresponding responses in heart rate (HR), and mean arterial pressure (MAP) were also compared. Results: Statistically significant differences were seen at 30th second of intubation between group I and group II in HR [107.8±13.417in group I and 126.2±10.996 in group II], MAP [84.8±4.637 in group I and 98.4±8.6 in group II] and IOP (11.07+1.9 mmHg in group I and 15.76+2.7 mmHg in group II; P = 0.0001)]. Similarly, significant differences were also observed at 2nd minute of intubation. Conclusion: We found that LMA insertion has less influence on intraocular pressure and hemodynamic response and it is associated with less postoperative complications in children undergoing elective ophthalmic procedures under general anaesthesia.