skip to main content

Comparison of Laryngeal Mask Airway and Endotracheal Tube on Intraocular Pressure in Vitrectomy

1Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Diponegoro University/ Dr. Kariadi General Hospital, Semarang, Indonesia

2Faculty of Medicine, Diponegoro University, Semarang, Indonesia

Received: 29 Jul 2024; Revised: 8 Aug 2024; Accepted: 3 Oct 2024; Available online: 10 Oct 2024.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)
Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

Citation Format:
Cover Image
Abstract

Background: Increased intraocular pressure (IOP) is a common complication after vitrectomy. Tracheal intubation and insertion of a laryngeal mask airway (LMA) are noxious stimuli that can increase IOP.

Objective: To analyze the difference between the use of LMA and an endotracheal tube (ETT) on the increase in IOP in vitrectomy.

Method: Experimental study with a randomized controlled trial design in 28 patients undergoing vitrectomy who met the inclusion and exclusion criteria. Subjects were divided into 2 groups with the use of LMA and ETT. Intraocular pressure (IOP) was measured using a Schiotz tonometer before induction of anesthesia, 5 minutes after intubation, 5 minutes before extubation, 5 minutes after extubation and 24 hours after vitrectomy in healthy eyes. The analysis was carried out with the unpaired T-test and the alternative Mann Whitney test, the results were significant if the p value <0.05.

Results: The mean IOP in the LMA group was 11.71 ± 1.90 mHg before induction of anesthesia; 11.04 ± 1.71 mmHg 5 min after induction; 10.86 ± 1.44 mmHg 5 min before discharge; 12.11 ± 1,49 mmHg after removal and 12.21 ± 2.63 mmHg 24 hours after discharge. The mean IOP in the ETT group was 11.05 ± 2.57 mHg before induction of anesthesia; 14.26 ± 2.59 mmHg 5 min after induction; 11.71 ± 1.90 mmHg 5 min before extubation; 14.70 ± 0,98 mmHg after extubation and 12.74 ± 1.82 mmHg 24 hours after extubation. A significant difference in IOP was found after ETT intubation and extubation (p < 0,05).

Conclusion: Endotracheal tube (ETT) significantly increases IOP compared to LMA during intubation and extubation in vitrectomy surgery.

Note: This article has supplementary file(s).

Fulltext View|Download |  Research Instrument
Ethical Clearance
Subject
Type Research Instrument
  Download (364KB)    Indexing metadata
 Research Instrument
Copyright Transfer Agreement
Subject
Type Research Instrument
  Download (312KB)    Indexing metadata
 Research Instrument
Untitled
Subject
Type Research Instrument
  View (85KB)    Indexing metadata
Keywords: airway management; endotracheal tube; intraocular pressure; laryngeal mask airway; vitrectomy

Article Metrics:

  1. American Society of Retina Specialist. Vitrectomy [Internet]. 2021 [cited 2021 Apr 29]. Available from: https://www.asrs.org/patients/retinal-diseases/25/vitrectomy
  2. Fang Y, Long Q, Wang X, Jiang R, Sun X. Intraocular pressure 1 year after vitrectomy in eyes without a history of glaucoma or ocular hypertension. Clin Ophthalmol [Internet]. 2017 Nov 22;11:2091–7. Available from: https://pubmed.ncbi.nlm.nih.gov/29200822
  3. Obsa MS, kanche ZZ, Olana Fite R, Tura TS, Adema BG, Kinfe AA, et al. Effect of Laryngeal Mask Airway Insertion on Intraocular Pressure Response: Systematic Review and Meta-Analysis. Cattano D, editor. Anesthesiol Res Pract [Internet]. 2020;2020:7858434. Available from: https://doi.org/10.1155/2020/7858434
  4. Kiliçkan L, Baykara N, Gürkan Y, Toker K. The effect on intraocular pressure of endotracheal intubation or laryngeal mask use during TIVA without the use of muscle relaxants. Acta Anaesthesiol Scand. 1999 Mar;43(3):343–6
  5. Madan R, Tamilselvan P, Sadhasivam S, Shende D, Gupta V, Kaul HL. Intra-ocular pressure and haemodynamic changes after tracheal intubation and extubation: a comparative study in glaucomatous and nonglaucomatous children. Anaesthesia [Internet]. 2000 Apr 1;55(4):380–4. Available from: https://doi.org/10.1046/j.1365-2044.2000.01213.x
  6. Ismail SA, Bisher NA, Kandil HW, Mowafi HA, Atawia HA. 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
  7. Bhardwaj N, Yaddanapudi S, Singh S, Pandav SS. Insertion of laryngeal mask airway does not increase the intraocular pressure in children with glaucoma Insertion of laryngeal mask airway does not increase the intraocular pressure in children with glaucoma. 2011;(May 2021)
  8. Ali Shiri AA, Naderi M, Jadidi KH, Nourian V, Bolouki Moghadam Y. Comparing the effect of laryngeal mask airway and endotracheal tube insertion on intraocular pressure. J Maz Univ Med Sci [Internet]. 2010;20(77):47–51. Available from: https://www.sid.ir/en/journal/ViewPaper.aspx?id=188369
  9. Bharti N, Mohanty B, Bithal PK, Dash M, Dash HH. Intra-ocular pressure changes associated with intubation with the intubating laryngeal mask airway compared with conventional laryngoscopy. 2008;431–5
  10. Jo DH, Park JG, Kim MH. Comparative Effects of Laryngeal Mask Airway Insertion and Endotracheal Intubation on Intraocular Pressure during Induction with Propofol. Korean J Anesth [Internet]. 1998 Aug;35(2):290–4. Available from: https://doi.org/10.4097/kjae.1998.35.2.290
  11. Omar SA, Abdelrahman AH, Abdelgaleel W, Mohamed KA. Comparative study between laryngeal mask airway and endotracheal tube as regard the effect on intraocular pressure and hemodynamic response in pediatrics undergoing congenital glaucoma surgery. 2017;21(3)
  12. J PM, Geeta A. Comparative study of intraocular pressure changes with laryngeal mask airway and endotracheal tube. 2012;3(2):279–82
  13. Gulati M, Mohta M, Ahuja S, Gupta VP. Comparison of laryngeal mask airway with tracheal tube for ophthalmic surgery in paediatric patients. Anaesth Intensive Care. 2004 Jun;32(3):383–9
  14. Gökçen B. The effect of low dose rocuronium on intraocular pressure in laryngeal mask airway usage. MEJ Anesth. 2011;21(1):35-8
  15. Phaughat P, Kiran S, Khurana A, Hooda S. Effect Of LMA-Classic And LMA-Proseal Insertion On Intraocular Pressure In Adult Patients . 2012;30(2):1–5
  16. Dar SA, Deka S, Dasand N, Mir MA, Mir AA. Proseal LMA Versus Endotracheal Tube A Clinical Comparative Study of its Different Effects in Paediatric Patients Undergoing Lower Abdominal Surgeries. 2016;3(5):1301–5
  17. Lalwani J, Dubey KP, Sahu BS, Shah PJ. ProSeal laryngeal mask airway: An alternative to endotracheal intubation in paediatric patients for short duration surgical procedures. 2010;54(6):541–5

Last update:

No citation recorded.

Last update: 2024-11-06 01:10:49

No citation recorded.