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Comparison of dexmedetomidine–propofol vs. fentanyl–propofol for laryngeal mask insertion

Published online by Cambridge University Press:  01 August 2008

F. Uzümcügil ,
O. Canbay ,
N. Celebi ,
A. H. Karagoz  and
S. Ozgen
F. Uzümcügil*
Affiliation:
Hacettepe University School of Medicine, Anesthesiology and Reanimation, Ankara, Turkey
O. Canbay
Affiliation:
Hacettepe University School of Medicine, Anesthesiology and Reanimation, Ankara, Turkey
N. Celebi
Affiliation:
Hacettepe University School of Medicine, Anesthesiology and Reanimation, Ankara, Turkey
A. H. Karagoz
Affiliation:
Hacettepe University School of Medicine, Anesthesiology and Reanimation, Ankara, Turkey
S. Ozgen
Affiliation:
Hacettepe University School of Medicine, Anesthesiology and Reanimation, Ankara, Turkey
*
Correspondence to: Filiz Uzümcügil, Department of Anesthesiology and Reanimation, Hacettepe University, Ankara, Turkey. E-mail: filizd@hacettepe.edu.tr; Tel: +90 312 3051250; Fax: +90 312 3109600
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Summary

Background and objectives

There have been many studies to find the optimum anaesthetics to provide excellent conditions for laryngeal mask insertion. We compared the effects of dexmedetomidine administered before propofol, on laryngeal mask insertion with fentanyl combined with propofol.

Methods

In all, 52 patients, ASA I–II, scheduled to have minor urological procedures were randomized into two groups. Group F received 1 μg kg−1 fentanyl (in 10 mL normal saline) and Group D received 1 μg kg−1 dexmedetomidine (in 10 mL normal saline). We used 1.5 mg kg−1 propofol for induction and 50% N2O and 1.5% sevoflurane in oxygen for maintenance. We observed jaw mobility (1: fully relaxed; 2: mild resistance; 3: tight but opens; 4: closed), coughing or movement (1: none; 2: one or two coughs; 3: three or more coughs; 4: bucking/movement) and other events such as spontaneous ventilation, breath holding, expiratory stridor and lacrimation. In each category, scores <2 were acceptable for laryngeal mask insertion.

Results

More patients developed apnoea and their apnoea times were longer in Group F than Group D (P < 0.001). Respiratory rates increased in Group D (P < 0.001). Adverse events during laryngeal mask insertion were similar. The reductions in systolic and mean blood pressures were greater in Group F (systolic: P < 0.05, mean: P < 0.01). Emergence times were shorter in Group F than in Group D (P < 0.001).

Conclusion

Dexmedetomidine, when used before propofol induction provides successful laryngeal mask insertion comparable to fentanyl, while preserving respiratory functions more than fentanyl.

Keywords

DEXMEDETOMIDINELARYNGEAL MASKSPROPOFOLFENTANYLCARDIOVASCULAR RESPONSES
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 8 , August 2008 , pp. 675 - 680
Copyright
Copyright © European Society of Anaesthesiology 2008

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