The use of remifentanil to facilitate the insertion of the laryngeal mask airway.
Propofol is often used as an IV induction drug for anesthesia and the insertion of a laryngeal mask airway (LMA). As a sole anesthetic, it may be associated with undesirable airway responses such as coughing and gagging. We conducted a randomized, double-blinded study to compare the conditions during insertion of the LMA in 120 patients who received normal saline (Group P), remifentanil 0.25 microg/kg (Group R1), or remifentanil 0.5 microg/kg (Group R2) before the induction of anesthesia with IV propofol. The addition of remifentanil significantly improved the conditions of insertion; in Group R1, 82.5% (33 of 40 patients), and in Group R2, 85.0% (34 of 40 patients) had excellent insertion conditions as compared with the Control group P, 32.5% (13 of 40 patients). Patients in Group P were apneic for a mean (SD) time of 85 (38) s, 186 (75) s in group R1, and 284 (130) s in group R2. There was a lesser decrease in mean arterial blood pressure in group R1. We conclude that remifentanil 0.25 microg/kg, when administered after IV propofol 2.5 mg/kg, provides excellent conditions for insertion of the LMA with minimal hemodynamic disturbances.


CONCLUSIONS
Small-dose remifentanil can provide excellent conditions for laryngeal mask airway insertion with minimal hemodynamic disturbances.
Lee
M P
MP
Department of Anaesthesia and Intensive Care, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Hong Kong Special Administrative Region, China.
Kua
J S
JS
Chiu
W K
WK
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000494:pharmacology*; D015742:Propofol / Q000494:pharmacology; D000077208:Remifentanil
D000701:Analgesics, Opioid; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol