Comparison of dexmedetomidine-propofol vs. fentanyl-propofol for laryngeal mask insertion.
OBJECTIVE
There have been many studies to find the optimum anaesthetics to provide excellent conditions for laryngeal mask insertion. We compared the effects of dexmedetomidine administered before propofol, on laryngeal mask insertion with fentanyl combined with propofol.


METHODS
In all, 52 patients, ASA I-II, scheduled to have minor urological procedures were randomized into two groups. Group F received 1 microg kg(-1) fentanyl (in 10 mL normal saline) and Group D received 1 microg kg(-1) dexmedetomidine (in 10 mL normal saline). We used 1.5 mg kg(-1) propofol for induction and 50% N2O and 1.5% sevoflurane in oxygen for maintenance. We observed jaw mobility (1: fully relaxed; 2: mild resistance; 3: tight but opens; 4: closed), coughing or movement (1: none; 2: one or two coughs; 3: three or more coughs; 4: bucking/movement) and other events such as spontaneous ventilation, breath holding, expiratory stridor and lacrimation. In each category, scores <2 were acceptable for laryngeal mask insertion.


RESULTS
More patients developed apnoea and their apnoea times were longer in Group F than Group D (P < 0.001). Respiratory rates increased in Group D (P < 0.001). Adverse events during laryngeal mask insertion were similar. The reductions in systolic and mean blood pressures were greater in Group F (systolic: P < 0.05, mean: P < 0.01). Emergence times were shorter in Group F than in Group D (P < 0.001).


CONCLUSIONS
Dexmedetomidine, when used before propofol induction provides successful laryngeal mask insertion comparable to fentanyl, while preserving respiratory functions more than fentanyl.
Uzümcügil
F
F
Hacettepe University School of Medicine, Anesthesiology and Reanimation, Ankara, Turkey. filizd@hacettepe.edu.tr
Canbay
O
O
Celebi
N
N
Karagoz
A H
AH
Ozgen
S
S
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D020927:Dexmedetomidine / Q000008:administration & dosage*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects; D015742:Propofol / Q000008:administration & dosage; D011446:Prospective Studies; D012119:Respiration / Q000187:drug effects; D013997:Time Factors
D019162:Anesthetics, Combined; D020927:Dexmedetomidine; D005283:Fentanyl; D015742:Propofol