Comparison of Dexmedetomidine-Propofol versus Fentanyl-Propofol on Insertion Conditions of Proseal Laryngeal Mask Airway

Abstract

Introduction: Proseal Laryngeal Mask Airway (PLMA) is a newer supraglottic airway device that requires adequate depth of anaesthesia and suppression of upper airway reflexes thereby providing optimal insertion conditions. Aim: To compare dexmedetomidine and fentanyl for co-induction with propofol with respect to PLMA insertion conditions, haemodynamic variation and the total dose requirement of propofol. Materials and Methods: This was a prospective randomized double-blinded study conducted in 60 cases of American Society of Anaesthesiologists (ASA) class I/II undergoing elective surgery under general anaesthesia. They were randomly divided into two equal groups, D and F, each receiving 1μg/ kg of dexmedetomidine and fentanyl respectively followed by Propofol 2.5mg/kg as per protocol. The ease of PLMA insertion was Young’s Criteria and Modified scheme of Lund and Stovener. The haemodynamic parameters (mean heart rate, mean arterial pressure, Respiratory rate, SPO2 ) were monitored at: Baseline, Pre-medication, Pre PLMA, Post LMA (at insertion), 1, 3, 5, 10, 15 and 20 minutes. Results: PLMA insertion conditions and haemodynamics were comparable between the dexmedetomidine-propofol and fentanyl-propofol groups according to the Young’s criteria and Modified scheme of Lund and Stovener. Total induction dose of propofol and its increments were significantly reduced in the dexmedetomidine group. Conclusion: Dexmedetomidine and fentanyl when both used individually for co-induction with propofol for PLMA insertion give excellent overall insertion conditions with haemodynamic stability. Dexmedetomidine also significantly reduces the requirements of induction dose propofol for PLMA insertion.

Keywords

• haemodynamic
• supraglottic airway device
• upper airway reflexes