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  • Title: Insertion of laryngeal mask airway does not increase the intraocular pressure in children with glaucoma.
    Author: Bhardwaj N, Yaddanapudi S, Singh S, Pandav SS.
    Journal: Paediatr Anaesth; 2011 Oct; 21(10):1036-40. PubMed ID: 21838823.
    Abstract:
    OBJECTIVES: It is hypothesized that in children with glaucoma, the insertion of laryngeal mask airway (LMA) will cause lesser rise in intraocular pressure (IOP) than tracheal tube (TT). AIM: To compare the IOP response to LMA and TT insertion in children with glaucoma. METHODS/MATERIALS: A prospective, randomized, single-blind study was conducted in 30 glaucomatous ASA-1 children, aged 1-10 years scheduled to undergo trabeculectomy. Anesthesia was induced with halothane and maintained for 5 min with 1 MAC of halothane after administering atracurium 0.5 mg·kg(-1) following which LMA or TT was introduced. IOP was measured in both the eyes before and after insertion of airway device for 5 min. RESULTS: The IOP increased significantly from 27.3 ± 5.2 to 31.2 ± 5.4 mmHg (P < 0.001) after tracheal intubation but returned to baseline within 5 min. The IOP did not change from the baseline after insertion of LMA. The IOP was significantly higher in group TT compared to group LMA at 2 min (P = 0.004) and 5 min (P = 0.01) after the device insertion. The heart rate (HR) increased significantly after tracheal intubation and returned to baseline 4 min after intubation. The HR increase was significantly more in TT group compared to LMA group at all times of observation. Both systolic blood pressure (SBP; P = 0.01) and diastolic blood pressure (DBP; P = 0.02) showed an increase at 1 min in children in group TT. CONCLUSION: Insertion of LMA in glaucomatous children is not associated with an increased IOP response or cardiovascular changes.
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