Randomized double blind comparison of ketamine – propofol and fentanyl – propofol for the insertion of laryngeal mask airway in children

Abstract

The ideal combination that provides smooth insertion conditions with minimal side effects has not been identified, particularly in children. In this study, 70 children of age 3-12 years are divided randomly into 2 groups: Group 1-Group-F-Fentanyl (n=35) received Fentanyl 2μg/kg and Group 2-Group –K- Ketamine (n=35) received Ketamine 0.5mg/kg before induction of anaesthesia. Baseline heart rate and arterial blood pressure were measured. Vital parameters (Heart rate and Arterial Blood Pressure) were measured before induction, before LMA insertion and thereafter at 1, 3 and 5 minutes after LMA insertion. Ideal LMA insertion conditions were evaluated with six variables by blinded observer: mouth opening, gagging, head and limb movements, laryngospasm and resistance to insertion. Also the apnoea time was noted. The incidence of head/limb movements was statistically significant and Group Propofol – Ketamine showed 22% compared to Fentanyl-Propofol group (2.8%) Coughing/gagging was seen in 2.86% of both the groups. Resistance to insertion was statistically significant with p value of 0.0268 showing more in Propofol + Ketamine. There was no statistical significance in the occurrence of restricted mouth opening, restriction to LMA insertion and occurrence of swallowing between the two groups.