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Laryngeal mask airway insertion using propofol without muscle relaxants: a comparative study of pretreatment with midazolam or fentanyl

Published online by Cambridge University Press:  16 August 2006

K. Nakazawa ,
Y. Hikawa ,
M. Maeda ,
N. Tanaka ,
S. Ishikawa ,
K. Makita  and
K. Amaha
K. Nakazawa
Affiliation:
Department of Anaesthesiology and Critical Care Medicine, School of Medicine, Tokyo Medical & Dental University, 1-5-45 Yushima, Bunkyo-ku, Japan
Y. Hikawa
Affiliation:
Department of Anaesthesia, Tokyo Metropolitan Hospital of Fuchu, 2-9-2 Musashidai, Fuchu-city, Tokyo, Japan
M. Maeda
Affiliation:
Department of Anaesthesia, Tokyo Metropolitan Hospital of Fuchu, 2-9-2 Musashidai, Fuchu-city, Tokyo, Japan
N. Tanaka
Affiliation:
Department of Anaesthesiology and Critical Care Medicine, School of Medicine, Tokyo Medical & Dental University, 1-5-45 Yushima, Bunkyo-ku, Japan
S. Ishikawa
Affiliation:
Department of Anaesthesiology and Critical Care Medicine, School of Medicine, Tokyo Medical & Dental University, 1-5-45 Yushima, Bunkyo-ku, Japan
K. Makita
Affiliation:
Department of Anaesthesiology and Critical Care Medicine, School of Medicine, Tokyo Medical & Dental University, 1-5-45 Yushima, Bunkyo-ku, Japan
K. Amaha
Affiliation:
Department of Anaesthesiology and Critical Care Medicine, School of Medicine, Tokyo Medical & Dental University, 1-5-45 Yushima, Bunkyo-ku, Japan
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Abstract

We determined the effects of pretreatment with midazolam or fentanyl on the ease of laryngeal mask airway insertion using propofol without a muscle relaxant. One hundred and eighty ASA class I or II patients were randomly allocated to one of three groups, 60 patients per group, to receive either placebo (Group C), midazolam 0.05 mg kg−1 (Group M) or fentanyl 2 μg kg−1 (Group F), respectively. Following intravenous administration of these drugs, Group C received propofol 2.5 (Group C-2.5) or 3.0 mg kg−1 (Group C-3.0). Group M and Group F received propofol 2.0 or 2.5 mg kg−1 (Group M-2.0, M-2.5, F-2.0 and F-2.5, respectively). There was a smaller incidence of severe head and limb movements on LMA insertion in Group M-2.5, Group F-2.0 and Group F-2.5 than in Group C-2.5. Airway obstruction and inadequate jaw relaxation, which were occasionally recognized in Group C and Group F patients, were not observed in Group M-2.5. Overall the ease of LMA insertion was significantly better in Group M-2.0, Group M-2.5 and Group F-2.5 than in Group C 2.5, however, the blood pressure in Group F after LMA insertion was significantly lower than in Group M. We conclude that pretreatment with midazolam 0.05 mg combined with propofol 2.5 mg kg−1 provides safe and satisfactory conditions for LMA insertion.

Keywords

laryngeal mask airwayanaestheticspropofolmidazolamfentanyl
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 16 , Issue 8 , August 1999 , pp. 550 - 555
Copyright
1999 European Society of Anaesthesiology

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