ABSTRACT
Introduction: Propofol a short acting intravenous anaestheticis widely used with various adjuncts to facilitate improvedinsertion conditions of Proseal Laryneal Mask Airway(PLMA). We compared the median effective dose (ED 50)propofol requirement and insertion conditions of PLMA withsaline - propofol, dexmedetomidine - propofol and fentanyl -propofol.Material and Methods: This was a prospective randomizeddouble blind study conducted in 100 adult patients of AmericanSociety of Anaesthesiology (ASA) class I/II scheduled toundergo elective surgical procedures. They were randomlyallocated into four groups of 25 each - Group N normal saline,Group F1 fentanyl 1 mcg/kg, Group F2 fentanyl 2mcg/kg andGroup D dexmedetomidine 1mcg/kg. The study drug wasdiluted in 50ml saline and infused over 10 minutes followedby a predetermined dose of propofol as per Dixon’s up anddown method. The ease of PLMA insertion was assessed asper Muzi mouth opening score. Hemodynamic parameterswere observed starting from baseline (T0), at 10 min post testdrug infusion (T1), post propofol injection (T2), 1min postLMA insertion (T3) and till 3 minutes post LMA insertion(T4).Results: The ED50 of propofol for the insertion of PLMAwith normal saline, fentanyl (1mcg/kg), fentanyl (2 mcg/kg)and dexmedetomidine (1mcg/kg) as adjuncts were found outto be 3.25mg/kg, 2mg/kg, and 1.67mg/kg and 1.92mg/kgrespectively. PLMA insertion conditions and hemodynamicparameters were comparable between the four groups. Leastincidence of apnoea was noted in group D with only 8 patientsrequiring assisted ventilation.Conclusion: Dexmedetomidine significantly reduces therequirement of induction dose propofol for PLMA insertionwhile providing stable hemodynamic and excellent insertionconditions