BACKGROUND: This study was performed to evaluate the hemodynamic changes of insertion of a laryngeal mask airway ProSealTM (PLMATM) or tracheal intubation in hypertensive patients. METHODS: Twenty hypertensive patients, aged between 41 to 73 yrs, undergoing an elective surgery, were studied. All patients were allocated randomly to have their surgery performed with endotracheal intubation (Group ET, n = 10) or PLMA(TM) (Group PLMA, n = 10) and were studied for cardiovascular responses related to intubation or PLMA(TM) insertion. Anesthesia was induced with thiopental sodium and vecuronium intravenously. The lungs were then ventilated manually through a facemask with 1.0% enflurane in oxygen and maximal changes (%) in systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP) and heart rate (HR) were measured after tracheal intubation or PLMA(TM) insertion after anesthetic induction. RESULTS: The maximal changes (%) in SBP, DBP, MBP and HR were less in Group PLMA than in Group ET during the observation period (SBP: 7.2 +/- 6.8 vs 55.7 +/- 5.7, DBP: 7.3 +/- 6.3 vs 47.5 +/- 8.3, MBP: 7.9 +/- 6.9 vs 50.5 +/- 5.7, HR: 10.8 +/- 7.2 vs 48.2 +/- 6.1, P < 0.05). CONCLUSIONS: PLMA(TM) insertion elicited less hemodynamic change than tracheal intubation in hypertensive patients.