Comparative Study of Airway Management Devices ETT vs LMA

Abstract

Background: Effective airway management is a cornerstone of anesthetic practice, yet the optimal choice between endotracheal tubes (ETT) and laryngeal mask airways (LMA) in elective surgeries remains debated due to variable complication rates and clinical outcomes. The gap persists in comparative data from regional populations to inform evidence-based airway device selection. Objective: This study aimed to compare the safety, procedural efficiency, and patient satisfaction between ETT and LMA in patients undergoing elective surgeries, with specific focus on insertion attempts, complication rates, and recovery profiles. Methods: A cross-sectional comparative study was conducted in three tertiary hospitals in Lahore, Pakistan, involving 384 patients aged 50–70 years, evenly divided into ETT and LMA groups. Inclusion required ASA I–II status and BMI ≤35 kg/m². Patients with high aspiration risk or airway abnormalities were excluded. Data were collected via clinical observation and structured postoperative questionnaires. Primary outcomes included airway-related complications, insertion metrics, and satisfaction levels. SPSS v26 was used for statistical analysis, including Chi-square, t-tests, and odds ratios. Ethical approval was granted under the Helsinki Declaration. Results: LMA demonstrated significantly lower complication rates (airway trauma: 0% vs. 30.7%; OR=82.3, p<0.001) and faster insertion times (12s vs. 22s; p<0.001). Patient satisfaction was higher with LMA (mean score: 4.6 vs. 4.1; p<0.001). Conclusion: LMA is a clinically safer and more efficient alternative to ETT in elective surgeries, with superior patient comfort and fewer complications, supporting its integration into routine airway management protocols.