COMPARISON OF THE ENDOTRACHEAL TUBE AND LANRYNGEAL MASK ARIWAY IN DIFFICULT AIRWAY MANAGEMENT

Background: Effective airway management remains a cornerstone of emergency and surgical care, especially in patients with anticipated or unanticipated difficult airways. The choice of device can significantly impact patient outcomes. Among the available options, the endotracheal tube (ETT) and laryngeal mask airway (LMA) are widely used. However, the clinical superiority of one over the other in difficult airway scenarios continues to be a topic of ongoing investigation, particularly in resource-constrained or emergency settings. Objective: To compare the effectiveness of ETT and LMA in managing difficult airways in terms of insertion time, success rate, and complication frequency. Methods: A cross-sectional study was conducted over six months across three tertiary hospitals, enrolling 130 adult patients aged 18 years and above who required general anesthesia and met the criteria for difficult intubation. Patients were allocated to receive either an ETT or LMA based on the attending anesthesiologist’s clinical judgment. Insertion time was recorded in seconds, and any complications such as sore throat, airway trauma, or laryngospasm were documented. Data were analyzed using IBM SPSS Version 29. An independent t-test and chi-square test were applied to determine statistical significance, with p < 0.05 considered significant. Results: The mean insertion time for LMA was significantly shorter at 54.3 seconds compared to 183.6 seconds for ETT (p < 0.001). The first-attempt success rate was higher for LMA (84.6%) than ETT (30.8%) (p < 0.001). Complications were notably fewer with LMA (23.1%) than with ETT (53.8%) (p = 0.002), suggesting improved safety and ease of use with LMA in difficult airway cases. Conclusion: LMA proved to be a faster, safer, and more effective option compared to ETT in the management of difficult airways, especially in scenarios demanding rapid airway control. Further large-scale studies are recommended for broader validation.