Introduction: One of the most common problems during laryngoscopy involves sympathetic system stimulation and the subsequent hemodynamic changes. It is a key measure to maintain the hemodynamic stability of patients with cardiovascular diseases during induction of anesthesia. This study attempted to compare the hemodynamic effects of laryngeal mask airway and combitube.

Methods: This prospective clinical trial was conducted on a total of 142 candidate patients 18 to 60 years of age with ASA I and II undergoing elective surgery. Patients were randomly divided into three groups: (1) mask ventilation (control group) (2) laryngeal mask airway and (3) combitube. At the next stage, the systolic and diastolic blood pressures and heart rates were measured at the following points in time: baseline, after induction of anesthesia and before airway manipulation, 1, 3 and 5 minutes after ventilation. The findings were analyzed and P<0.05 was considered significant.

Results: Patients in all three groups were closely matched in terms of age, height, weight, sex and Mallampati score. The duration of combitube insertion was significantly longer than that of laryngeal mask airway (LMA) (P<0.05). The baseline and post-induction hemodynamic variables were similar in the three groups. The hemodynamic variations at the first minute were higher in the combitube group than the other two. At minute 3, the hemodynamic parameters in Groups 2 and 3 were significantly higher than those in Group 1. Moreover, diastolic blood pressure in Groups 2 and 3 was higher than that in Group 1 in the 5^th minute.

Conclusion: LMA insertion leads to lower hemodynamic responses in patients during airway management compared to combitube. This is can be an important issue in cardiovascular patients.