Comparison of Dexmedetomidine Propofol with Fentanyl Propofol for Laryngeal Mask Airway Insertion

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Comparison of Dexmedetomidine Propofol with Fentanyl Propofol for Laryngeal Mask Airway Insertion

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Why is it important?

Context: LMA secures airway better than face mask and also causes less hemodynamic stress than endotracheal tube insertion. We have done a study on, comparison of dexmedetomidine-propofol with fentanyl-propofol for laryngeal mask airway insertion. Aims: To compare efficacy of Dexmedetomidine–Propofol and Fentanyl–Propofol for LMA insertion in terms of ease of intubation using Muzi and colleagues scoring system; compare the hemodynamic responses to LMA insertion. Settings and Design: Prospective randomized double blind study Methods and Material: After obtaining institutional ethical committee approval, 110 ASA I and II patients were included. Group A patients were preoxygenated for 3 min, dexmedetomidine 1 mcg/kg over 2 min. 30 sec later propofol 2 mg/kg was given for induction, Group B patients were preoxygenated for 3 min, fentanyl 1 mcg/kg given over 2 min. 30 sec later propofol 2 mg/kg was given for induction. Parameters observed include HR, SBP, DBP, MAP, SpO2 and RR before insertion of LMA and after insertion of LMA. Statistical analysis used: SPSS (version 18.0) to analyze data (version 18.0), and Sigma-Stat 12.0 is used to decide sample size. Results: Dexmedetomidine group had better LMA insertion conditions like better jaw mobility, lesser incidence of cough and fewer incidence of breath holding spells. Moreover, reduction of hemodynamic parameters like SBP, DBP and MAP was more with fentanyl group than dexmedetomidine group. Conclusions: From our study we conclude that dexmedetomidine caused less respiratory depression and more stable hemodynamic conditions, compared to fentanyl. Thus we feel that dexmedetomidine can be used as an alternative to fentanyl with an advantage for LMA insertions in short surgical procedures.

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