Comparison of dexmedetomidine with fentanyl as intravenous adjuvants to propofol induction for LMA supreme insertion

Abstract

Objectives: To compare the efficacy, safety, hemodynamic stability, of Laryngeal mask airway supreme insertion using Dexmedetomidine as an adjuvant to Propofol.Method: The present double-blind, randomized, prospective study included sixty subjects in the age range 18-50 years of both sexes who are either Grade I / grade II undergoing elective surgery under general anesthesia. Random allocation into Groups A and B was done. Group A was administered with a 1µg/kg-loading dose of Dexmedetomidine over 10 minutes thereafter by infusion at dose of 0.7µg/Kg/Hr. Group B received a 1µg/kg-loading dose of fentanyl over 10 minutes, then infusion at dose of 0.7µg/Kg/Hr. After completion of the initial dose of either agent, propofol infusion was initiated at the dose of 100µg/kg/min titrated to keep BIS at 40-60 for Laryngeal mask airway supreme insertion. Hemodynamic parameters, BIS values, Insertion quality score, number of attempts, induction time, and doses of propofol are compared. Results: In groups, A and B laryngeal mask airway supreme insertion was accomplished in the first attempt in 84% and 80% of subjects respectively. The insertion quality score was better in group A.A significant difference in hemodynamic parameters and bisepctral index between the two groups from the end of infusion to 5 minutes after laryngeal mask airway unique insertion was noted. In group B 7(28%) reported sore throat postoperatively and 8 (32%) patients had pain on injection.Conclusion: Dexmedetomidine propofol combination provides better insertion quality, lower propofol consumption, and hemodynamic stability than propofol alone.