Comparison of intravenous induction with propofol to vital capacity breath induction with sevoflurane for insertion of laryngeal mask airway

Sugatha Prakash, Sreedevi J.

Abstract

Background: The increasing emphasis on day care anaesthesia has led to the greater use of laryngeal mask airway (LMA) as an alternative to tracheal intubation for short procedure surgeries. Satisfactory insertion of LMA after induction of anaesthesia requires sufficient depth for suppression of airway reflexes. This study was performed to compare intravenous induction with Propofol to vital capacity breath induction with sevoflurane for LMA insertion.

Methods: In this study 100 ASA 1 and ASA 2 patients aged between 20 and 40 years, undergoing short surgical procedures lasting 30 to 60 minutes, were included. The P group received   Inj. Propofol 2.5 mg/kg IV whereas the S group received Sevoflurane 8% vital capacity breaths. After the loss of eyelash reflex, which was considered the end point of induction, the LMA insertion was attempted by an anaesthesiologist blinded to the induction technique. The data that was recorded was induction time with both the drugs, characteristics of LMA insertion, hemodynamic responses and complications if any. The number of attempts at insertion was also noted.

Results: Induction time was 60.1±8.98 secs for propofol induction and 72.8±15.86 for sevoflurane vital capacity breath induction which was found statistically significant. The insertion conditions were found excellent in 88% in the propofol group and 90% in the sevoflurane group which was comparable. There was no statistically significant difference found in the time or characteristics of insertion between both the groups. No incidence of complications was found in both groups.  

Conclusions: Induction with sevoflurane vital capacity breath inhalation compared equally with induction with intravenous propofol for LMA insertion in patients undergoing short surgical procedures.

Keywords

Laryngeal mask airway, Propofol, Sevoflurane

Full Text:

PDF

References

Scanlon P, Carey M, Power M. Patient response to laryngeal mask insertion after inductionof anaesthesia with propofol or thiopentone. Can J Anaes. 1993;40(9):816-8.

Fredman B, Nathanson MH, Smith I, Wan J, Klein K, White PF. Sevoflurane for outpatient anaesthesia: A comparison with Propofol. Anaesth Analg. 1995;81:823-8.

Kirbride DA, Parker JL, Williams GD, Buggy DJ. Induction of anaesthesia in the elderly ambulatory patient: a double blinded comparison of propofol and sevoflurane. Anaesth Analg. 2001;93:1185-7.

Muzi M, Robinson BJ, Ebert TJ. Induction of anaesthesia and tracheal intubation with Sevoflurane in adults. Anaesthesiology. 1996;85:536-43.

Hall JE, Stewart JIM, Harmer M. Single breath inhalation induction of sevoflurane anaesthesia with and without nitrous oxide: A feasibility study in adults and comparison with an intravenous bolus of propofol. Anaesth.1997;52:410-5.

Baker CE, Sevoflurane SI. A comparison between vital capacity and tidal breathing technique for the induction of anaesthesia and laryngeal mask airway placement. Anaesth. 1999;54:841-4.

Thwaites A, Edmendes S, Smith I. Inhalation Induction with Sevoflurane: A double blind comparison with Propofol. British J Anaesth. 1997;78:358-61.

Priya V, Divatia JV, Dasgupta D. A comparison of Propofol vs Sevoflurane for laryngeal mask airway insertion. Indian J Anaesth. 2002;46(1):31-4.

Sivalingam P, Kandasamy R, Madhavan G, Dhakshinamoorthy P. Condition for laryngeal Mask Airway insertion . A comparison of propofol vs Sevoflurane with or without alfentanil. Anaesth. 1999;54:271-5.

Sayyid SMS, Aouad MT, Tana SK, Daaboul DG, Deeb PG, Massouh FM. A comparison of sevoflurane-propofol versus sevoflurane or propofol for laryngeal mask airway insertion in adults. Anaesth Analg. 2005;100:1204-9.

Jellish SW, Lien CA, Fontenot JH, Hall R. The comparative effect of sevoflurane versus propofol in the induction and maintenance of anaesthesia in adult patients. Anaesth Analg. 1996;82:479-85.

Ti LK, Chow MYH, Lee TL. Comparison of propofol with sevoflurane for laryngeal mask airway insertion in adults. Anaesth Analg. 1999;88:908 -12.

Yogendran S, Prabhu A, Handy A, Mcguire G, Imaeengiaye C, Wong J, et al. Vital Capacityand patient controlled sevoflurane inhalationresult in similar induction characteristics. Can J Anesth. 2005;152:1145-9.

Kati I, Demirel CB, Huseyinoglu UA, Silay E, Yagmur C, Coskuner I. Comparison of propofol and sevoflurane for Laryngeal Mask Airway Insertion. Tohuker J Exp Med. 2003;200:111-8.