Comparison of Propofol and Sevoflurane for Insertion of LMA in Children

Abstract

Propofol is a drug of choice for induction of laryngeal mask airway insertion due to its ability to depress oropharyngeal and cough reflexes. Sevoflurane is a no pungent inhalation anesthetic agent and can be used as an induction agent. The present study was performed in 100 patients to compare Propofol with Sevoflurane for laryngeal mask airway insertion in adults. Propofol induction in Group-A and inhalational sevoflurane induction in Group-B. The present study was done in 300 patients from November 2021 to March 2022, to compare Propofol with Sevoflurane for laryngeal mask airway insertion in adults. Pre-anesthetic check-up of the patients was done a day prior to surgery. Patients were randomly divided into 2 groups, Group-A and Group-B, each with 50 patients. In Group-A: propofol induction 3 mg/kg intravenously within 30 seconds with Lidocaine 0.3 mg/kg. In Group-B: induction was achieved with inhalational sevoflurane 8% and nitrous oxide 50% in oxygen. All the important parameters like pulse rate, alteration in blood pressure, respiration rate, and SPO2 % of all the patients were recorded in case record form. Other clinical parameters like loss of eyelash reflex, jaw relaxation. To compare two different doses of propofol for laryngeal mask airway (LMA) insertion in children undergoing out‑patient surgery. In a double‑blind randomized clinical trial, 120 children undergoing out‑patient surgery were recruited to receive intravenous propofol in a dose of either 2.5 mg/kg (group 1) or 3.5 mg/kg (group 2) for induction Pre‑medication with intravenous midazolam (0.03 mg/kg) and fentanyl (1 μg/kg) was given to all patients and induction of anesthesia was initiated with lidocaine (1 mg/kg) prior to giving propofol. Hemodynamic changes, potential complications, quality of the number of attempts at LMA insertion and confirmed airway were compared between two groups. Results shows Systolic and diastolic blood pressure, heart rate, peripheral oxygen saturation and intraoperative complications were not different between the groups (P>0.05). LMA insertion was successful on the first attempt in 55 (93.2%) and 54 (91.5%) cases in group 1 and group 2, respectively (P>0.05). The efficiency of established airways proved to be adequate in all patients of both groups. It would seem that propofol doses of 2.5 and 3.5 mg/kg are both equally effective for LMA insertion. In this study, mean age of Group-A was 28.7±8.31years and in the Group-B was 29.2±8.46 (p>0.05). Mean weight in Group-A was 58.11±3.29 Kg and in Group-B was 58.48±4.12, (p>0.05). Both groups consisted of males more in numbers, in Group-A was 64% males’ participants and in Group-B were 53.33% males. Group B patients had the time for loss of eyelash reflex, Time to jaw relaxation, Time taken to successful insertion of Laryngeal Mask Airway compared to group A. Number of patients with successful LMA insertion at first attempt was greater in group A than in group B. 1 attempt needed for LMA insertion in group A while 2 attempts needed in group B. However, more patients were required propofol for successful intubation in group A when compared to group B. The apnea time was longer in group A than group B, and the frequency of apnea was higher in group A than group B. The incidence of overall complications of induction of anesthesia, exciting movement was higher in group A than group B. Cough, laryngospasm was observed in group B but not in group A. Key words: LMA, BP, SpO², RR.