Abstract

The laryngeal mask airway ensures better control of airway leaving the anesthesiologist’s hands free and avoids the disadvantages of endotracheal intubation like pressor response, sore throat, croup, hoarseness postoperatively. Ideal induction agent for LMA insertion would provide loss of consciousness, jaw relaxation and absence of upper airway reflexes rapidly without cardiorespiratory compromise. Materials and Methods: A Comparative study of Sevoflurane and Propofol for laryngeal mask airway insertion in adults was done on 60 patients. The patients aged 18 to 60 years (ASA grade I and II) were randomized into two groups. Propofol 2 to 2.5 mg/kg was given in group P. Group S patients were induced with 8% Sevoflurane. Inj fentanyl 2µg/kg was given to both the groups after loss of verbal contact. Time taken for loss of eyelash reflex, loss of verbal contact, jaw relaxation and successful laryngeal mask airway insertion was compared. Also hemodynamic effects, ease of laryngeal mask airway insertion and side effects and complication were compared between the two groups. Observations: Time taken for Loss of verbal contact and loss of eyelash reflex were almost similar in both groups. Jaw relaxation had taken a longer time in Sevoflurane group (100.1 ± 7.4) seconds than Propofol group (88 ± 12.2) seconds with p value 0.0001 which was highly significant. With Sevoflurane group the LMA insertion has taken 116.3 ± 7.06 seconds while Propofol has taken 101.2 ± 13.2 seconds, with a P value 0.0001 which was significant. The number of attempts taken for LMA insertion in Propofol group (1.03± 0.18) was less compared with Sevoflurane (1.16 ± 0.37) but this was statistically not significant ( p value 0.23). Systolic blood pressure showed no significant changes except at two minutes where the Propofol group showed a marked decrease (108.1±7.4 ) mmHg as compared to Sevoflurane (113.1 ± 9.4) mmHg with a significant p value (0.02). Conclusion: Sevoflurane took longer time as compared to Propofol for jaw relaxation as well as laryngeal mask airway insertion, but the hemodynamics was maintained better with Sevoflurane than Propofol. The quality, safety and reliability of Sevoflurane single vital capacity breath induction anaesthesia made it an alternative to intravenous Propofol for the insertion of LMA in adults.

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