Abstract
Background: Propofol is the most popular induction agent for laryngeal mask airway (LMA) insertion in current anaesthesia practice however associated hypotension has been reported as its major disadvantage. Etomidate, which produces less hypotension, can be considered as an alternative agent for LMA insertion. Objectives: The objective of this study was to compare the hemodynamic effects of etomidate with propofol for induction of general anaesthesia (GA) for LMA. Ease of inserting LMA was also looked at. Material and Methods: It was a prospective randomized double blinded study. All ASA I and II patients of 15 - 60 years of age undergoing general anaesthesia with LMA for elective surgeries were included. Patients were induced with intravenous (I/V) fentanyl and induction agent either etomidate or propofol according to group randomization. LMA was inserted after 30 seconds. Intra-operative heart rate (HR), sys tolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), number of attempts and duration of LMA insertion were monitored. Results: There was no difference in the heart rate between the two groups. A significant drop was found for systolic blood pressure (SBP) in propofol group while diastolic blood pressure (DBP) was decreased in both the groups. In propofol group, successful insertion of LMA was achieved on the first attempt in 93.3% of patient as compared to 36.7% in etomidate group. Conclusion: Use of etomidate for induction of laryngeal mask anesthesia can prevent the hypotension following induction; however it may delay the insertion of laryngeal mask airway.
Highlights
laryngeal mask airway (LMA) has gained the wide acceptability for securing the airway in patients undergoing elective surgery under general anaesthesia (GA)
The objective of this study was to compare the hemodynamic effects of etomidate with propofol for induction of general anaesthesia (GA) for LMA
Use of etomidate for induction of laryngeal mask anesthesia can prevent the hypotension following induction; it may delay the insertion of laryngeal mask airway
Summary
LMA has gained the wide acceptability for securing the airway in patients undergoing elective surgery under general anaesthesia (GA). Etomidate produces less cardiovascular depression than other commonly used induction agents like thiopentone Na and propofol It is considered the induction agent of choice for high-risk patients with cardio respiratory diseases and for that reason it has been used for LMA insertion [2,3]. We hypothesized that etomidate with concurrent use of fentanyl could prevent the hypotension following induction of GA for LMA insertion. In this study we compared etomidate with propofol for hemodynamic effects and ease of insertion of LMA at induction of GA. Propofol is the most popular induction agent for laryngeal mask airway (LMA) insertion in current anaesthesia practice associated hypotension has been reported as its major disadvantage. Objectives: The objective of this study was to compare the hemodynamic effects of etomidate with propofol for induction of general anaesthesia (GA) for LMA. Conclusion: Use of etomidate for induction of laryngeal mask anesthesia can prevent the hypotension following induction; it may delay the insertion of laryngeal mask airway
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