Background and Objectives:Endotracheal intubation is the most important and crucial step during administration of general anesthesia. It is more so in pediatric patients with associated deformities of cleft lip, palate, and alveolus. Propofol, an intravenous (i.v.) induction agent, has profound depressant effect on airway reflexes with a quick and smoother induction. Similarly, sevoflurane, an inhalational agent, has relatively pleasant smell, low airway irritability, and more cardiostable properties. Hence, we sought to compare effectiveness of propofol with sevoflurane in achieving good intubation conditions without the use of muscle relaxants.Materials and Methods:In this prospective randomized study, eighty children belonging to American Society of Anesthesiologist physical status Class I and II, aged 1–10 years, scheduled for cleft surgery were included. All participants were premedicated. Patients were allotted to Group A and Group B randomly. Group A received propofol and Group B received sevoflurane as induction agents. Tracheal intubation was attempted in all patients at 150 s. Intubation conditions were assessed by using Steyn modification of Helbo–Hansen intubating conditions score. Statistical analysis was done using Student's t-test and Chi-square test with P < 0.05 regarded as significant.Results:Group B patients receiving sevoflurane had significantly more clinically acceptable intubation conditions than patients of Group A receiving i.v. propofol (P = 0.001).Conclusion:We conclude that intubation conditions using inhalational 8% sevoflurane are superior to i.v. propofol of 3 mg/kg for tracheal intubation without muscle relaxants in children undergoing cleft surgeries.
Introduction:Colonoscopy is a mildly painful procedure requiring conscious sedation. Though propofol is a widely used anesthetic agent in day-care procedures due to its rapid onset and quick recovery has a drawback of requiring resuscitation maneuvers more often than the conventional methods. Dexmedetomidine, a newly introduced, highly selective α2-adrenergic receptor agonist possessing hypnotic, sedative, anxiolytic, sympatholytic, and analgesic properties with impressive safety margin, needs to be explored for use in conscious sedation for colonoscopy procedure among South Indian population.Materials and Methods:A prospective randomized comparative study was conducted on patients aged between 25 and 60 years with the American Society of Anesthesiologist physical status classes I and II posted for colonoscopy under monitored anesthesia care. Study group was randomly divided into two groups and administered propofol and dexmedetomidine. The primary outcome variable was assessments of sedation scores between the two groups. Secondary outcome variables were pain score assessments, hemodynamic comparisons, and adverse events among the two groups. Appropriate statistical tests were applied to compare the findings.Results:After comparisons between the two groups, we found that patients on dexmedetomidine had similar sedation score as that of patients on propofol. However, there was a significantly higher incidence of systemic hypotension. Requirement of rescue analgesia and adverse events and other hemodynamic fluctuation were similar in both the groups.Conclusion:We conclude that dexmedetomidine has similar efficacy as propofol for conscious sedation required during colonoscopy. Occurrence of systolic hypotension was, however, significantly more among the group receiving dexmedetomidine.
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