Optimal concentrations of sevoflurane and propofol for laryngeal mask airway insertion in Chinese boys of different ages

Abstract

To investigate the optimal concentrations of sevoflurane and propofol for laryngeal mask airway (LMA) insertion in Chinese boys of different ages. 200 boys with ASA status I weighting 7 - 53 kg undergoing inguinal operation were divided into 4 groups (n = 50) according to age: Group A (aged 7 m-1 yr), Group B (1 - 3 yrs), Group C (4 - 6 yrs), and Group D (7 - 11 yrs). No premedication was given. General anesthesia was induced with propofol intravenous infusion at target effect-site concentration by target controlled infusion (TCI) using children Marsh model (Subgroups As, Bs, Cs, and Ds, 25 cases for each subgroup) or sevoflurane inhalation combined with 50% N2O (Subgroups Ap, Bp, Cp, and Dp, 25 cases for each subgroup) the optimal concentration was predetermined according to the modification of Dixon's up-and-down method. The size of LMA was determined according to the boy's weight and reverse technique was used to place LMA. The insertion conditions were noted as satisfactory when the jaw was relaxed, lash reflex disappeared, no coughing, gagging, swallowing, and laryngospasm was seen, and limb movement was minimal. The levels of ED(50) of P(ET)-sevoflurane for LMA insertion in Subgroups As, Bs, Cs, and Ds were 2.96% (95% CI 2.58% - 3.44%), 2.62% (95% CI 2.31% - 2.90%), 2.16% (95% CI 1.97% - 2.33%), and 1.89% (95% CI 1.66% - 2.24%) respectively. The levels of ED(50) of target effect site concentration with propofol for LMA insertion in Subgroups Ap, Bp, Cp, and Dp were 4.74 microg/ml (95% CI 4.49 - 5.13 microg/ml), 4.33 microg/ml (95% CI 4.07 - 4.62 microg/ml), 4.10 microg/ml (95% CI 3.90 - 4.31 microg/ml), and 3.65 microg/ml (95% CI 3.24 - 3.98 microg/ml) respectively. The ED(50) level of P(ET)-sevoflurane or target effect site concentration with propofol for LMA insertion in Chinese boys decreases gradually along with the increase of age.