A comparative study of vital capacity breath inhalation with sevoflurane versus intravenous propofol to aid laryngeal mask airway insertion in adults
Keywords:
Laryngeal mask airway (LMA), Vital capacity breath (VCB), Intravenous (IV), Sevoflurane, PropofolAbstract
Background: Laryngeal mask airway has already gained widespread acceptance as an alternative airway device and conduit for endotracheal intubation. Insertion of this Supraglottic Airway Device (SAD) to provide and maintain a seal around the laryngeal inlet for spontaneous ventilation as well as modest level of positive pressure ventilation requires a sufficient depth of anaesthesia and depression of airway reflexes to avoid adverse reactions like gagging, coughing, head and limb movements etc. This study was conducted with the intent to compare Vital Capacity Breath (VCB) inhalation with 8% sevoflurane versus intravenous (IV) propofol for quality and ease of insertion of Laryngeal Mask Airway (LMA) and associated complications
Methods: In this prospective, randomized study, 80 adult patients of ASA physical status I and II aged between 20 to 50 years, body weight <70 kg scheduled for short operative procedures under general anaesthesia were selected. The patients were divided into two groups. Group-S (n=40) were induced with 8% sevoflurane with 67% nitrous oxide in oxygen with a total gas flow of 8 litres per minute and group-P (n=40) were induced with injection propofol 2.5 mg/kg body weight intravenously.
Results: Insertion of LMA at first attempt was 92.5% with sevoflurane (VCB) and 95% with propofol. Time to loss of consciousness was 35.98 ± 6.23s and 36.26 ± 5.65s in group S and group P respectively. Complications were similar in both the groups.
Conclusions: A vital capacity induction with sevoflurane shows a slight faster loss of consciousness. The time to successful LMA insertion at 1st attempt and the incidence of side effects were similar in both the group (P >0.05).
References
Brain AIG. The Laryngeal mask: a new concept in airway management. Br J Anaesth. 1983;55:801-5.
Benumof J. The laryngeal mask airway and the ASA difficult airway algorithm. Anesthesiology. 1996;84:686-9.
Blake DW, Dawson P, Donnan G, Bjorksten A. Propofol induction for laryngeal mask airway insertion: dose requirement and cardio respiratory effects. Anaesth Intensive Care. 1992;20(4):479-83.
Scanlon P, Carey M, Power M, Kirby F. Patient response to laryngeal mask airway insertion after induction with propofol or thiopentone. Can J Anaesth. 1993;40(9):816-8.
Ti LK, Chow MYH, Lee TL. Comparison of sevoflurane with propofol for laryngeal mask airway insertion in adults. Anaesth Analg. 1999;88:908-12.
Siddik-Sayyed SM, Aouad MT, Taha SK, Daaboul DG, Deeb PG, Massouh FM, et al. A comparison of sevoflurane-propofol versus sevoflurane or propofol for laryngeal mask airway insertion in adults. Anaesth Analg. 2005;100:1204-9.
Philip BK, Lombard LL, Roaf ER, Drager LR, Calalang I, Philip JH. Comparison of vital capacity induction with sevoflurane to intravenous induction with propofol for adult ambulatory anaesthesia. Anaesth Analg. 1999;89:623-7.
Hall JE, Stewart JIM, Harmer M. Single breath inhalational induction with sevoflurane anaesthesia with and without nitrous oxide; a feasibility study in adults and comparison with an intravenous bolus of propofol. Anaesthesia. 1997;52:410-5.
Priya V, Divatia JV, Dasgupta D. A comparison of propofol versus sevoflurane for laryngeal mask airway insertion. Indian J Anaesth. 2002;46(1):31-4.
Rashdi S, Iftikhar N, Iqbal F, Aftab S, Khan AB. Comparison of sevoflurane and propofol for I-gel insertion. Pak J Surg. 2013;29(1):23-5.
Koppula R, Shenoy A. Comparison of sevoflurane with propofol for laryngeal mask airway insertion in adults. J Anaesth Clin Pharmacol. 2005;21(3):271-4.
Zahoor MU, Mansoor R, Buland K, Kazi WA, Ehsan-ul-Haq M. Comparison of haemodynamic changes after laryngeal mask airway insertion with propofol versus sevoflurane. Pak Armed Forces Med J. 2010;60(3):410-4.
