A controlled, double blind, study of adding Nalbuphine to Propofol for laryngeal mask insertion conditions and hemodynamics in adults

Abstract

Purpose: The purpose of this study was to evaluate laryngeal mask airway placement conditions achieved with Nalbuphine/Propofol combination when given intravenously as well as hemodynamic changes if any. Methods: 60 ASA grade 1 and 11 patients of age group 20–60 years, scheduled for general anesthesia with spontaneous breathing were randomly allocated to receive intravenously either Fentanyl 2 μg/kg, controlled group (Group F, n = 30) or Nalbuphine 0.2 mg/kg (Group N, n = 30), before induction of anesthesia with Propofol 2–2.5 mg/kg. Heart rate and arterial blood pressure were measured before induction of anesthesia and at 1, 3, and 5 min after LMA insertion. Assessment of LMA insertion was done using 6 variables: mouth opening, gagging, swallowing, head and limb movements, laryngospasm and resistance to insertion. Incidence and duration of apnea were recorded. Results: The incidence of coughing/gagging was higher in the F group (50%) compared to the N group (30%), (P = 0.019). Swallowing was also statistically significant (P = 0.017), being higher in F group (50%), compared to N group (16.6%). Limb moving followed the same pattern being higher in the F group (40%) compared to (13.3%) in the N group, (P = 0.008). Laryngospasm was seen in neither group. There was also statistically significant difference (P = 0.007) in the incidence of apnea between the control group (F) 86.6% and (N) group. Heart rate variation and MAP changes were not statistically significant in either F or N groups. Conclusion: The addition of Nalbuphine to Propofol for LMA insertion provides excellent insertion conditions with stable hemodynamics in adults.

Keywords

• Laryngeal mask airway (LMA)
• American Society of Anesthetists (ASA)
• Mean arterial pressure (MAP)