The evolution of airway management highlights a shift towards supraglottic airway devices (SGAs) due to their advantages in minimizing post-operative complications and improving patient outcomes. Several studies have compared SGAs like LMA Protector to endotracheal tubes (ETT) in various surgical procedures, demonstrating benefits such as reduced hemodynamic stress response, lower incidence of post-operative symptoms, and better ventilatory parameters. Meta-analyses have also shown that second-generation SGAs provide better oropharyngeal leak pressure, with the LMA Protector exhibiting the highest efficacy. However, these devices have been sparingly studied in terms of ICP response. Rise in ICP noticed during tracheal stimulation during intubation would be well tolerated by healthy patients, but may be detrimental for certain subset of patients.Thus the current study aims to compare the effectiveness of the Laryngeal Mask Airway Protector (a second-generation supraglottic airway device) with the traditional endotracheal tube (ETT) in multiple aspects, primarily by assessing their impact on intracranial pressure as measured through Optic nerve sheath diamter (ONSD).The other comparative aspects include hemodynamic response, clinical performance of the devices and post-operative complications associated with their usage. The hypothesis is that SGAs will result in reduced alterations in ONSD, indicating potentially safer airway management.

Participants will be randomly assigned to either the supraglottic airway (SGA) group or the ETT group.The study protocol outlines thorough pre anaesthesia workup including physical examinations, various tests and assessment of difficult airway. Patients will be advised on fasting and will be pre-medicated according to institutional guidelines. During anesthesia induction, standard procedures will be followed, including pre-oxygenation, induction with propofol and neuromuscular blockade. Airway management will vary based on group allocation, either with a supraglottic airway device (LMA Protector) or endotracheal intubation (ETT), with specific techniques outlined for each. Monitoring parameters, including hemodynamic parameters and optic nerve sheath diameter (ONSD), will be closely observed at designated time points pre and post-insertion of the airway devices. Analgesics and anti-emetics will be administered as necessary, and reversal agents will be used post-surgery. The study will also evaluate the post-operative complications like sore throat, dysphagia and dysphonia.