Comparison of sevoflurane and propofol for laryngeal mask airway insertion and pressor response in patients undergoing gynecological procedures

Chavan, Shirishkumar; Gujar, Sandhya; Shinde, Gourish Prakash

doi:10.4103/joacp.joacp_313_15

Cited by 10 publications

(11 citation statements)

References 6 publications

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“…1,2 Supraglottic airway devices provides a useful alternative for airway management during spontaneous or controlled ventilation in adults, as they do not require the use of laryngoscope for insertion, are non-invasive so, associated with less hemodynamic changes and airway manipulation. 3 The laryngeal mask airway supreme (LMA Supreme™) is a single use supraglottic airway device made of polyvinyl chloride has a firm airway tube shaped at a 90° angle to facilitate insertion without digital guidance. It has a modified conical cuff which gives it a high-pressure seal and better performance during mechanical ventilation and a gastric channel running along the posterior midline through the airway tube to facilitate the passage of a gastric tube which allows functional separation of the respiratory and digestive systems.…”

Section: Introductionmentioning

confidence: 99%

Comparison of laryngeal mask airway supreme™ versus endotracheal intubation in positive pressure ventilation with muscle relaxant for intraoperative and postoperative conditions

2017

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Background: Laryngeal Mask Airways are increasingly being used now a day as an option to endotracheal intubation, as it is less invasive and causes less discomfort in the postoperative period. The aim of this study was to evaluate the clinical use of the laryngeal mask airway SupremeTM in patients undergoing elective gynaecological surgeries under general anaesthesia and compare it with endotracheal intubation.Methods: 60 ASA I and II females, having BMI <30kg.m-2 in the range of 20-50 years of age, scheduled for elective gynaecological surgeries were randomly allocated to one of the two groups according to the device used (LMAS or ETT). Time required for insertion, number of attempts, hemodynamic response to insertion/removal and incidence of immediate and late postoperative complications such as coughing, laryngospasm, sore throat, dysphagia etc. were assessed.Results: Number of attempts for successful insertion was similar but time required for LMA Supreme™ insertion was significantly less (25.40±12.90 versus 33.27±14.82 sec) similarly, time required for nasogastric tube insertion was significantly more in ETT group (30.28±16.22 versus 21.93±12.64 sec). No episode of failed ventilation or hypoxia was recorded. The changes in hemodynamic parameters were significantly higher after endotracheal intubation and during extubation. Incidence of postoperative complications was significantly higher after endotracheal intubation (p<0.05).Conclusions: The LMA Supreme™ is a suitable alternative to endotracheal intubation during general anaesthesia for elective gynaecological surgeries with the added advantage of less hemodynamic response during airway management and lower incidence of postoperative complications.

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Section: Introductionmentioning

confidence: 99%

Comparison of laryngeal mask airway supreme™ versus endotracheal intubation in positive pressure ventilation with muscle relaxant for intraoperative and postoperative conditions

2017

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“…10 Emergency agitation is a known side effect of sevoflurane which is commonly seen in children during recovery phase of anaesthesia. 11 Sudden removal of anaesthetic agent with low blood gas solubility coefficient can lead to emergence. 11 Godet et al in a study said that recovery profile was similar with both propofol and sevoflurane but emergence reaction was seen more with sevoflurane.…”

Section: Discussionmentioning

confidence: 99%

“…11 Sudden removal of anaesthetic agent with low blood gas solubility coefficient can lead to emergence. 11 Godet et al in a study said that recovery profile was similar with both propofol and sevoflurane but emergence reaction was seen more with sevoflurane. 12 We did not see any emergence in our study groups.…”

Section: Discussionmentioning

confidence: 99%

Comparison of haemodynamic and Recovery Profile Using Propofol and Sevoflurane for Otorhinolaryngology Procedures

Kandavar¹,

Padmanabha²

2019

jebmh

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BACKGROUND Induction and maintenance of general anaesthesia is done with both intravenous and inhalational agents. This observational study was conducted to compare haemodynamic and recovery profile using propofol and sevoflurane for maintenance of anaesthesia. We wanted to compare haemodynamic parameters like heart rate and mean arterial pressure of sevoflurane and propofol. METHODS We included 64 adult patients, belonging to ASA I and II, coming for otorhinolaryngology procedures. They were allocated into 2 groups using closed envelope method. Both groups were induced with propofol 2 mg/Kg, fentanyl 2 mcg/Kg and vecuronium 0.1 mg/Kg and intubated with appropriately sized endotracheal tube. After confirmation of endotracheal tube, oxygen 50% and nitrous oxide 50% and propofol at 100-200 mcg/Kg or sevoflurane at 1.5-2% was started. haemodynamic changes like heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were recorded from the beginning till the end of the procedure. Haemodynamic profile was noted at the time of extubation and 5 minutes after extubation. Time taken for extubation and spontaneous eye opening were also noted. Post-operative nausea and vomiting (PONV) were looked for in immediate postoperative period and after 4 hours. RESULTS In the study, propofol group had lower heart rate compared to sevoflurane group which was statistically significant (p= 0.0001). Mean arterial pressure was also lower in the propofol compared to sevoflurane group and was statistically significant (p= 0.0001). Recovery profile was similar in both groups which was not statistically significant. Post-operative nausea and vomiting were seen in both groups in the immediate post-operative period. PONV was noted in 37.5% patients in sevoflurane group and 6.75% in propofol group but it was not seen in propofol group after four hours. CONCLUSIONS We found that propofol which was used for maintenance of anaesthesia had better haemodynamic stability compared to sevoflurane; but the time taken for extubation and recovery was similar in both groups. PONV was noted in both the groups but was lesser in propofol group.

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“…[ 11 15 ] While 8% sevoflurane by vital capacity breath technique was found to be comparable as the patient can be induced within 1–3 breaths. [ 16 17 ]…”

Section: Discussionmentioning

confidence: 99%

“…This corroborates the results obtained by Chavan et al . [ 16 ] and Patel et al . [ 25 ] Patient movement was another parameter where no difference was found between groups.…”

Section: Discussionmentioning

confidence: 99%

Comparison of inhalational vital capacity induction with sevoflurane to intravenous induction with propofol for insertion of laryngeal mask airway in adults: A randomized study

Udaybhaskar¹,

Singam²,

Dodeja³

et al. 2018

Anesth Essays Res

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Background:Since the development of laryngeal mask airway (LMA) by Dr. Brain, it is extensively used for airway management; satisfactory insertion of LMA requires administration of an induction agent and suppression of airway reflexes. Among intravenous agents, propofol has been the drug of choice in view of better safety profile, relaxation and depression of upper airway reflexes. Sevoflurane on the other hand, with pleasant odor, nonirritating to the airways and with bronchodilator property are best among the volatile induction agents. While it is true both propofol and sevoflurane have their merits, still both have certain limitations. We aimed to compare the quality and ease of LMA insertion, hemodynamic changes, and complications with inhalation of 8% sevoflurane vital capacity breath and propofol.Materials and Methods:A prospective randomized study of 100 American Society of Anaesthesiologists’ Class I and II patients was conducted equal distribution among two groups with 50 each undergoing gynecological procedures under general anesthesia. Group P received injection propofol and Group S received sevoflurane. At the end point of induction, the LMA insertion was attempted. Scoring systems were used to grade the conditions for insertion of the LMA. Induction characteristics, hemodynamic changes, and complications were assessed.Results:Sevoflurane took a longer time for induction and jaw relaxation than propofol. There was no statistically significant difference between the two groups, with respect to LMA insertion time, and conditions. Apnea time was more in propofol group. Fall in heart rate and mean blood pressure was more in propofol.Conclusion:Propofol is associated with faster induction while sevoflurane is associated with good hemodynamic stability.

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Comparison of sevoflurane and propofol for laryngeal mask airway insertion and pressor response in patients undergoing gynecological procedures

Cited by 10 publications

References 6 publications

Comparison of laryngeal mask airway supreme™ versus endotracheal intubation in positive pressure ventilation with muscle relaxant for intraoperative and postoperative conditions

Comparison of laryngeal mask airway supreme™ versus endotracheal intubation in positive pressure ventilation with muscle relaxant for intraoperative and postoperative conditions

Comparison of haemodynamic and Recovery Profile Using Propofol and Sevoflurane for Otorhinolaryngology Procedures

Comparison of inhalational vital capacity induction with sevoflurane to intravenous induction with propofol for insertion of laryngeal mask airway in adults: A randomized study

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