Laryngeal mask airway insertion with remifentanil.
BACKGROUND
We conducted a study to find out the best conditions for LMA insertion with two different doses of remifentanil added to propofol and propofol administered alone.


METHODS
Following hospital clinical research ethics committee approval, 60 ASA I-II patients were included in the randomized double-blind study. Following premedication, patients received i.v. 0.25 microg kg(-1) remifentanil (Group R1), 0.50 microg kg(-1) remifentanil (Group R2) or normal saline (Group P) in 60 sec. Then following 20 mg lidocaine, propofol 2 mg kg(-1) were administered in R1 and R2 groups and 2.5 mg kg(-1) in P group. Ease of insertion of LMA and airway quality at first attempt was assessed. Number of attempts of LMA insertion, apnea time, additional propofol requirement and hemodynamic changes were recorded.


RESULTS
There were no significant differences in demographic data among the patients. Apnea time (mean +/- SEM) was significantly shorter in P group (34.09 +/- 5.5 sec) compared to R1 (82.5 +/- 12.7 sec) and R2 (87.2 +/- 6.6 sec) groups (p = 0.01 and p = 0.001). Ease of LMA insertion was assessed as grade 1 in 100% of patients in R2 group while 65% in R1 and 30% in P groups. Undesirable responses following LMA insertion were observed in 54% of patients in P group.


CONCLUSIONS
Propofol given 2.5 mg kg(-1) alone is not a good agent for LMA insertion. Remifentanil used in both doses combined with propofol provides good and excellent conditions for insertion of LMA with minimal hemodynamic disturbances.
Yazicioglu
H
H
Turkey Yuksek Ihtisas Hospital, Department of Anesthesiology and Reanimation, Ankara, Turkey. hija001@hotmail.com
Muslu
S
S
Yamak
B
B
Erdemli
O
O
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage / Q000009:adverse effects; D000328:Adult; D000368:Aged; D018686:Anesthetics, Intravenous; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects; D017214:Laryngeal Masks / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000008:administration & dosage / Q000009:adverse effects; D015742:Propofol; D000077208:Remifentanil; D012129:Respiratory Function Tests
D000759:Adjuvants, Anesthesia; D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol