Publications of Faculty of Medicine:HEMODYNAMIC AND CATECHOLAMINE STRESS RESPONSES TO INSERTION OF THE COMBITUBE AS AN ALTERNATIVE AIRWAY MANAGEMENT IN GENERAL ANAESTHESIA FOR CAESAREAN SECTION : Abstract

The introduction of Combitube to the field of airway management brought about a solution of the problem of difficult airway in trauma patients and during cardiopulmonary resuscitation. This trial was designed to assess the efficacy of Combitube in preventing the lethal complications of failed intubation during caesarean section and compare the haemodynamic and stress response to the device with that resulting from endotracheal intubation. Forty-five healthy parturients scheduled for CS were randomized into three equal groups. Combitube was inserted blindly in group I and facilitated by laryngoscopy in group IL In group III, endotracheal intubation was performed under laryngoscopy. Patients were assessed for the degree of difficulty of insertion of the Combitube, manifestation of regurgitation or trauma to the oropharynx, haemodynamic changes and hormonal response to Combitube insertion and endotracheal intubation. There was no significant difference in the degree of ease on introduction of Combitube in group I as compared to group IL Combitube proved to be a safeguard against regurgitation as group I and II were compared to group III. A high incidence of trauma was noticed in group I during blind insertion of Combitube as compared to laryngoscopy aided insertion in group II or endotracheal intubation in group III. Laryngoscopy aided insertion of Combitube (group II) or endotracheal intubation (group III) produced a significant increase in heart rate as compared to blind insertion in group I. Comparison between groups II & Ill showed a significant increase in I-1R in group II