Intraocular pressure response to airway management: Comparison between LMA Supreme® and C-MAC® videolaryngoscope in day care surgery

Abstract

Background: Airway maintenance procedures during anesthesia are usually associated with a rise in intraocular pressure (IOP). This is an important issue especially in vulnerable patients. In the present study we compared the rise in IOP with two different group of airway devices i.e. Laryngeal mask airway Supreme (LMA-S) and endotracheal intubation (ETT) using C-MAC® videolaryngoscope (VLS). Methodology: The present study was conducted on 100 adult patients of ages >18 yrs, of either sex, belonging to American Society of Anesthesiologist (ASA) I and II, scheduled to undergo non-ophthalmic elective surgery under general anesthesia. Patients were divided into two equal groups of 50 each, Group A and Group B. In group A (n = 50), lubricated appropriate sized LMA-S was inserted and in Group B (n=50), lubricated appropriate sized ETT was inserted by an anesthesiologist using VLS. IOP was measured in right eye just before insertion of device and subsequently at 1 min, 3 min, 5 min and 10 min after insertion of device. Hemodynamic parameters were recorded along with IOP measurement. Results: Both the groups were comparable regarding demographic data (p > 0.05), ASA grade (p = 0.069), and Mallampati grade (MPG) (p = 0.646). Airway establishment time (p = 0.011) was significantly less with C-MAC VLS. IOP were comparable at all measurement times, e.g., 1 min (p = 0.216), 3 min (p = 0.093), 5 min (p = 0.859) and 10 min (p = 0.060) after insertion of each device. Hemodynamic parameters measured were also comparable between two groups (p > 0.05). Conclusion: Both LMA Supreme and intubation using C-MAC® videolaryngoscope are safe regarding rise in intraocular pressure. Both methods can be safely used for airway management in suitable patients. Key words: Airway; Anesthesia; Intraocular pressure; LMA; Endotracheal intubation Citation: Kaur H, Singh G, Singh J, Kaur, Dhawan M, Singh A. Intraocular pressure response to airway management: Comparison between LMA Supreme and C-MAC® videolaryngoscope in day care surgery. Anaesth. pain intensive care 2020;24(6):__ Received: 27 January 2020, Revised: 12 May 2020, Reviewed: 25 October 2020, Accepted: 27 October 2020