A comparative study of vital capacity breath inhalation with sevoflurane versus intravenous propofol to aid laryngeal mask airway insertion in adults

Abstract

In1981, Dr. A.I.G.Brain 1 designed the prototype of LMA. It is an excellent device to maintain airway in selected surgeries and obviates the need for endotracheal intubation. In year 1996, LMA was incorporated in ASA difficult airway algorithm. 2 Other advantages of LMA, like smoother transition from anaesthesia to emergence with LMA in situ and requirement of lesser skill for ABSTRACT 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. GroupS (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 1 st attempt and the incidence of side effects were similar in both the group (P >0.05).

A tertiary hospital based comparative study of intravenous propofol versus inhalational sevoflurane in the insertion of laryngeal mask airway in adults in rural Andhra Pradesh

“…Insertion conditions, which again was at par with our findings [9] . Similar findings were also observed in the study done by Sarkar M et al [13] . The time to completion of successful LMA insertion was faster in the propofol group in our study which was similar to the finding of Rashdi S et al, who compared the insertion of I-gel with either sevoflurane or propofol and found that the insertion time was comparatively short with propofol [10] .…”

“…The baseline haemodynamic data (MAP and pulse rate) did not differ between two groups however the mean arterial pressure decreased and pulse rate increased during induction and LMA insertion in both the groups which was not statistically significant. These findings can be compared with the results found by Sahar M. Siddik-Sayyid et al, [6] Hall JE et al [8] and Zahoor MU et al [12] Sarkar M et al [13] . In conclusion, Sevoflurane may be a useful alternative to propofol in providing anaesthesia to aid LMA.…”

Comparative evaluation of sevoflurane and propofol to facilitate insertion of supra glottic airway device

“…Earlier studies [6][7][8] conducted, comparing propofol and sevoflurane for LMA insertion in adults and concluded that induction time and insertion time was lesser with propofol. The number of attempts required for I-gel insertion and incidence of complications were similar in both groups.…”

Comparison of inhalational vital capacity induction with sevoflurane to intravenous induction with propofol for insertion of laryngeal mask airway in adults: A randomized study

“…Sarkar et al . [ 22 ] and Siddik-Sayyid et al . [ 21 ] observed similar faster jaw relaxation with propofol than sevoflurane.…”

“…[ 14 ] and Soomro et al . [ 23 ] In the study by Sarkar et al .,[ 22 ] the mean LMA insertion time in both propofol and sevoflurane induction was prolonged, due to their study design of waiting for 1 min after loss of eyelash reflex before insertion and calculating insertion time from initiation of drug to insertion of LMA.…”