Role of opioids as coinduction agent with propofol and their effect on apnea time, recovery time, and sedation score

Abstract

Background:Laryngeal mask airway (LMA) is a supraglottic device which requires lesser depth of anaesthesia, evokes lesser hemodynamic response and causes lesser stimulation of airway as compared to traditional definitive airway device endotracheal tube. Its placement is possible without muscle relaxants thereby allowing maintenance of anaesthesia on spontaneous respiration thus preventing apnoea or minimizing apnoea time. Propofol, the commonly used induction agent, causes cardiorespiratory depression at higher induction doses. To attenuate this, co-induction agents combined with propofol has been a regular I/V anaesthetic technique these days.Aim:Comparing apnoea time, recovery time and sedation scores using propofol-fentanyl and propofol-butorphanol combination.Methodology:Hundred patients scheduled for various elective surgical procedures were randomly selected and divided into two groups of 50 each. As coinduction drug Group F received fentanyl and Group B received butorphanol. In both the groups induction was achieved with I/V propofol and LMA was placed. Apnoea time was noted after induction. Recovery time and sedation scores were recorded after anaesthetic agents were turned off.Results:As compared to group F apnoea time was significantly less and recovery time was significantly more in group B (P < 0.05). Statistically postoperative sedation was significantly higher in group B than in group F at 1/2 hr but clinically, majority were responding to verbal commands. At 1 hour no significant difference in sedation was noted between the groups.Conclusion:Considering respiratory and recovery profile propofol -butorphanol combination is a safer alternative to propofol-fentanyl combination for LMA insertion.

Sevoflurane is an effective adjuvant to propofol-based total intravenous anesthesia for attenuating cough reflex in nonintubated video-assisted thoracoscopic surgery

“…Taking together, we used fentanyl and sevoflurane for modifying depth of anesthesia to attenuate cough and the result was consistent with previous studies reporting that depth of anesthesia can modify cough reflex. [ 30 – 32 ] However, there was no significant difference in BIS value between 2 groups before OLV and during surgery in this study.…”

Perioperative complications of pediatric otorhinolaryngological operations

“…During anesthesia our patients were administered the drugs characterized by an expressed vagotonic and sympathoplegic effect, what became the priory of the maximum number of respiratory complications. [ 17 18 19 20 ] The conducted study showed that pain was a unique significant postoperative complication, which was proved by the studies of other scientists. [ 21 22 23 ]…”

Outcomes of Propofol or Thiopental Sodium and Oral Midazolam as an Induction Agent for Day Care Surgery

“…They are inexpensive when patient safely discharged early. This analysis aimed to discover a cost-effective induction drug, an alternative to propofol that is preferred drug but quite costly in day-cases surgeries [15][16] . Concomitant 0.25 mg / kg oral midazolam induction and conventional intravenous thiopental at a compact dosage of 2.5 mg / kg resulted in recovery almost similar to that of propofol [17][18] .…”