Comparative Evaluation Of Propofol-Ketamine And Propofol-Fentanyl For Laryngeal Mask Airway Insertion

This was a double-blinded,randomized, controlled study, conducted in adult, ASA 1 and 2 patients,undergoing elective surgical procedures. 120 patients, satisfying the inclusionand exclusion criteria, were randomly allocated into two groups,propofol-ketamine (PK) and propofol-fentanyl (PF), each group consisting of 60patients, by sealed envelope technique. The study was designed to compare thehemodynamic responses to induction & insertion of LMA and the insertionconditions between propofol- ketamine and propofol- fentanyl combinations.

All patients received 0.3mg Glycopyrrolate, intramuscular,half an hour before the procedure.  Inthe operating room, after recording the baseline parameters- oxygen saturation(SpO2), Mean Blood Pressure (BP), Pulse Rate (PR) and End Tidalcarbon dioxide (EtCO2), 1µg/ kg Fentanyl to the PF group & 0.5mg/kg Ketamine to the PK group was given intravenously. Induction of anesthesiawas initiated with 1% Propofol @ 1mg/ kg/ min with a syringe pump, till thepatient tolerated a full jaw thrust, which was considered as the end point forLMA insertion. On reaching the end point, LMA insertion was attempted throughthe classical approach, as described by Brain. Proper position of LMA wasascertained by the ability to easily ventilate the lungs (assessed by chestmovement), without any significant resistance or leak and no significantresistance to expiration with rapid refilling of the reservoir bag. Acapnograph was also used to assess adequacy of ventilation.