prospective, randomized, controlled trial study of comparison of two techniques for laryngeal mask airway insertion

ABSTRACT

In this study we compared the use of an intravenous propofol/propofol auto-co-induction technique to propofol/midazolam for laryngeal mask insertion. We also studied the incidence of undesirable effects in relation to LMA insertion. In this prospective, randomized, controlled trial study, 60 adults belonging to ASA class 1 and 2 were randomly divided in three groups; Groupl- Saline-propofol; Group 2- Propofol-midazolam; Group 3-Propofol-propofol. The induction characteristics reviewing various parameters like the induction dose required, hemodynamic changes and the cost of induction were observed. Hemodynamic variables including heart rate [HR], systolic blood pressure [SBP], diastolic blood pressure [DBP], and mean arterial pressure [MAP] were recorded at 2, 4 and 6 minutes post induction. We noticed a decrease in HR, SBP, and DBP and MAP in all 3 groups which was not statistically significant. The total induction dose of propofol in Group 2 [106.3 +/- 21.26 mg] and Group 3 [136.50 +/- 20.29 mg] was significantly lower than Group 1 [1 59.75 +31 .39 mg] but not statistically different between group 2 and 3. The total cost of induction was significantly reduced in the midazolam co-induction group i.e. Group 2. The number of patients suffering from apnea differed significantly between 3 groups i.e. 12 patients in Group 1, 6 patients in Group 2 and 1 patient in Group 3. No significant difference was seen in 3 groups in incidence of hiccups, excitatory phenomenon or laryngospasm. Propofol co-induction [Group 2] and propofol auto co-induction is safe alternative to propofol induction and is more cost effective as they decrease the cost of induction. Midazolam co-induction is more economical than propofol auto co-induction