Comparative evaluation of sevoflurane and propofol to facilitate insertion of supra glottic airway device

Abstract

: Propofol has been used since ages as induction agent to aid in insertion of Supraglottic airway devices however its side effects like hypotension, apnea and pain on injection do coexist. To avoid these side effects sevoflurane has been studied and well recognized because of its sweet smelling property. We conducted this study with primary aim to compare the insertion conditions such as no. of attempts for insertion, hemodynamic variations and awakening after surgery. The secondary aim was to note the adverse effects associated with Sevoflurane and propofol.We included sixty female patients of age 18-65 years graded as ASA I and II undergoing short gynecological procedures. Patients were induced with Sevoflurane 8% or IV Propofol 2mg/kg. Attempts for I-gel insertion, jaw relaxation, biting, coughing, gagging, laryngospasm and hemodynamic pressor response and awakening after surgery were noted.Induction time with Propofol is less compared to Sevoflurane. I-Gel insertion time with Sevoflurane and Propofol is insignificant (p value= 0.93). 25 patients in Group S and 27 patients in group P had very easy insertion of I-gel. 23 patients in Group S and 27 patients in Group P had relaxed jaw. None of the patients in both groups experienced laryngospasm.Propofol provided better conditions for I-gel insertion with manageable hypotension while the patients induced with Sevoflurane were hemodynamically more stable but the jaw relaxation was less as compared to that provided by propofol. Induction with 8% Sevoflurane by Vital Capacity Breath (VCB) technique can be an alternative for induction in high risk patients. Also the awakening from anaesthesia is faster with sevoflurane and is more suitable for patients demanding early discharge after day care surgeries.