Assessment of Efficacy of Dexmedetomidine and Fentanyl in Combination with Propofol for Ease of Laryngeal Mask Airway Insertion and Haemodynamic Stability

Abstract

Background: Laryngeal mask airway (LMA) insertion requires anesthesia and suppression of airway reflexes. In search of an optimal drug, we compared dexmedetomidine and fentanyl, in combination with Propofol for ease of LMA insertion and haemodynamic stability. Method: Total 120 patients belonging to ASA status I & II posted for elective surgery were randomly divided into 2 equal groups. Both the groups received I.V glycopyrrolate 4μg/kg prior to receiving the study drugs. Group D received dexmedetomidine I.V 1μg/kg diluted in 10cc NS over 10min while group F received fentanyl I.V 2μg/kg diluted in 10cc NS over 10min. Induction was done with IV Propofol 2mg/kg in both the groups. After 90 sec, LMA insertion (no 3 for females and no.4 for males) was done by the consultant anaesthesiologist blinded to the technique. Results: Jaw opening, ease of LMA insertion, requirement of additional Propofol was clinically insignificant and comparable between two groups. Cough though seen more in fentanyl group, (p=0.042) while the incidence of bradycardia was more with dexmedetomidine group. Between the two groups, the change in blood pressure from baseline to 30sec after induction and upto 10min after LMA insertion was statistically insignificant. Within the individual groups, the changes in the blood pressure reached statistical significance. These changes did not reach a clinical significance and required no additional medication. Conclusion: Either dexmedetomidine or fentanyl when used along with propofol provides comparable conditions for the ease of LMA insertion with stable haemodynamic parameters in pre-hydrated, healthy and young patients.