COMPARISON OF THE REINFORCED LARYNGEAL MASK AIRWAY AND ENDO TRACHEAL TUBE INTUBATION IN ADULT TONSILLECTOMY

Background: The endotracheal tube is considered the standard for airway control and protection during general anaesthesia, especially when the airway is ‘shared’ between the anaesthetist and the surgeon. This has been challenged by the introduction of the reinforced laryngeal mask airway. It does not kink, is less traumatic during insertion and is better tolerated during emergence The objectives of this study were to compare the ease of use, safety in airway maintenance and postoperative outcome using either reinforced laryngeal mask airway or endotracheal tube intubation in adult tonsillectomy. Material & Methods: This cross-sectional comparative study was carried out at Departments of ENT & Anaesthesia, Combined Military Hospital Attock, from October 2011 to May 2012. Seventy male recruits, aged 18-22 years, American Society of Anaesthesiologists grade 1, undergoing elective tonsillectomy were randomized into two groups. Laryngeal mask airway group was anesthetized using the modified reinforced laryngeal mask airway, while endotracheal tube intubation group was anesthetized using endotracheal tube. Safety, ease of use, and status during recovery were monitored and compared. Results: Both the groups were comparable with respect to age and weight. Four per cent patients in reinforced laryngeal mask airway group required repositioning of the tube vs. no patient in endotracheal tube group. Frequency of good surgical access was significantly higher in endotracheal tube group as compared to reinforced laryngeal mask airway group. Laryngospasm, cough and desaturation were almost similar in both the groups. Conclusion: Reinforced laryngeal mask airway seems a safe and logical substitute for endotracheal tube in adult tonsillectomy in experienced hands.