Blockbuster Laryngeal Mask Airway Versus Endotracheal Tube for Airway Management in Off-Pump Cardiothoracic Surgery: A Randomized Controlled Study.

Background and aims The increasing use of supraglottic airway devices has led to a shift in airway management practices. BlockBuster® Laryngeal Mask Airway (BLMA; Henan Tuoren Medical Device Co., Ltd., China) is a newer second-generation device, and its use in prolonged surgeries remains limited. Off-pump cardiothoracic surgeries are conventionally performed using endotracheal intubation, which may be associated with significant haemodynamic responses. Methods This prospective randomized study included 60 adult patients undergoing elective off-pump cardiothoracic surgeries, allocated into two groups of 30 each. Group A had the airway secured using a Blockbuster LMA, and Group B used an endotracheal tube. Time taken to achieve an effective airway, number of attempts, ease of insertion, intraoperative haemodynamic and ventilatory parameters, and post-operative complications were assessed. Results The time taken to achieve effective airway was significantly shorter in Group A compared to Group B (p<0.001). Haemodynamic parameters including heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure were significantly higher in Group B during the immediate period following airway securement (p<0.05). The incidence of post-operative sore throat was significantly higher in the endotracheal tube group (p<0.05). Ventilatory parameters were comparable between the two groups. Conclusion Blockbuster LMA is a suitable alternative to the endotracheal tube for airway management in patients undergoing off-pump cardiothoracic surgery, providing quicker airway establishment, better haemodynamic stability, effective ventilation, and fewer post-operative complications.