RESUMEN
BACKGROUND: Surgery and endotracheal intubation both causes an increase in metabolic stress response. This is further aggravated during laparoscopic surgeries. In this study we aimed at comparing hemodynamic and metabolic parameters which are reflective of intraoperative stress response while using I-GEL against endotracheal tube (ETT) during laparoscopic cholecystectomy. MATERIAL AND METHODS: This is a prospective randomized comparative study among 64 cases of American Society of Anesthesiologists(ASA) physical status class I and II, undergoing laparoscopic cholecystectomy who were randomly allocated into two groups of 32 each using computer generated random number table. Patients were put under general anesthesia using standard protocol. After anesthesia induction and 20 minutes after induction venous blood samples were obtained for measuring adrenalin, noradrenalin, dopamine and cortisol levels. Hemodynamic and respiratory parameters were recorded at the 1st, 5th, 15th, 30th and 45th minutes after the insertion of airway device. RESULTS: Although there was no significant difference regarding ventilatory parameters there was significant increase in heart rate at 1st and 45th minutes (p = 0.02 and 0.034) respectively and increase in mean arterial pressure at 15th and 30th minutes(p = 0.034 and 0.026) respectively in the ETT group compared to I-GEL group. Stress hormone intergroup analysis revealed significant increase in serum cortisol 20 minutes after induction in ETT group as compared to I-GEL group (p = 0.03). CONCLUSION: I-GEL usage is a suitable, effective and safe alternative to ETT in laparoscopic cholecystectomy patients with lower metabolic stress response.