A comparison to facilitate insertion of the laryngeal mask: term of recovery and postoperative nausea and vomiting after anesthesia with propofol- atracurium and thiopental-atracurium.
AbstractLaryngeal mask is a supraglothic instrument for ventilation of patients who are under anesthesia. Insertion of laryngeal mask requires maintaining sufficient depth of anesthesia to avoid airway reflex (gagging, coughing and spasms). The present study investigated two techniques of anesthesia with propofol-atracurium and thiopental-atracurium to facilitate insertion of the laryngeal mask, term of recovery and postoperative nausea and vomiting. In this prospective, randomized and double-blinded clinical trial, 224 patients undergoing elective laparoscopic class ASA one and two were studied. Patients were divided into two groups of 112 patients - one group with propofol anesthetic and thiopental-atracurium. Then after the induction of anesthesia neuromuscular hemodynamic changes, airway reflex (gagging, coughing and spasms), the ease of insertion of laryngeal mask and the frequency of patient movements' were recorded. The data were analyzed by SPSS V.18. Results indicated that anesthetic technique with propofol-atracurium provides better and more comfortable condition for insertion of laryngeal mask significantly (P<0.05). Hemodynamic changes during induction of anesthesia and five minutes after insertion of the laryngeal mask in first group was more than second one (P<0.05), and nausea and vomiting during recovery in propofol group was significantly lower than thiopental group (P<0.05). Using techniques of anesthesia with propofol - atracurium in inserting laryngeal mask airway in patients who have an indication for the use of this technique is better than anesthesia with thiopental -atracurium.
Henderson J. Airway management in the adult. In: Ronald D. Miller, editors. Text book of anesthesia. 7th ed. Philadelphia: Elsevier; 2010; p. 1573-610.
Uerpairojkit K, Charuluxananan S, Werawatganon T, et al. Profile Soft-Seal Cuff for General Anesthesia under Ambulatory Gynecologic. J Med Assoc Thai 2009;92(9):1184-90.
Maltby JR, Beriault MT, Waston NC, et al. The LMAProseal is an effective alternative to Tracheal Intubation for Laparoscopic Cholecystectomy. Can J Anesth 2002;49(8):857-62.
Deakin CD, Peters R, Tomlinson P, et al. securing the prehospital airway: a comparison of laryngeal mask insertion and endotracheal intubation by UK paramedics. Emerg Med J 2005;22(1):64-7.
Thomas J. Gal. Air way management. In: Ronald D. Miller, editors. Text book of anaesthesia. 6th ed. Philadelphia: Elsevier; 2005; p. 1617-52.
Parmet JL, Colonna-Romano P, Horrow JC, et al. The laryngeal mask airway reliably provides rescue ventilation in cases of unanticipated difficult tracheal intubation along with difficult mask ventilation. Anesth Analg 1998;87(3):661-5.
Miller RD, Eriksson LI, Fleisher JP, et al. Anesthesia. 7th ed. Philadelphia: Elsevier Pub; 2010; p. 1573-610, 2185-203.
Vukmir RB. Airway Management in the Critically III. New York: Parthenon Pub; 2001: p. 45-100.
Piper SN, Triem JG, Rohm KD, et al. ProSeal-Laryngeal mask versus endotracheal intubation in patients undergoing gynaecologic Laparoscopy. Anesthesiol Intensivmed Notfallmed Schmerzther 2004;39(3):132-7.
Gal TJ. Airway management. In: Miller RD, editor. Anesthesia. Philadelphia: Churchill Livingstone; 2005: p.1625-7.
Mizutamari E, Yano T, Ushijima K, et al. A comparison of postoperative sore throat after use of laryngeal mask airway and tracheal tube. J Anesth 2004;18(3):151-7.
Aghamohammadi D, Eydi M, Hosseinzadeh H, et al. Assessment of Mini-dose Succinylcholine Effect on Facilitating Laryngeal Mask Airway Insertion. J Cardiovasc Thorac Res 2013;5(1):17-21.
Jahanmirinezhad F, Kadivar E, Kamalipour H, et al. Laryngeal mask airway ease of insertion: Comparison between low dose cisatracurium and succinyl-choline. J Iranian Soc Anaesthesiol Intensive Care 2011;71(3):36-44.
Erhan E, Ugur G, Gunusen I, et al. Propofol - not thiopental or etomidate - with remifentanil provides adequate intubating conditions in the absence of neuromuscular blockade. Can J Anaesth 2003;50(2):108-15.
Kevin J, McGough E, Vacchiano C, et al. Comparison of the effects of propofol versus thiopental induction on postoperative outcomes following surgical procedures longer than 2 hours. AANA J 2003;71(3):215-22.
Bano F, Zafar S, Sabbar S, et al. Intravenous ketamine alternates injection pain and arterial pressure changes during the induction of anaesthesia with propofol. A comparison with lidocaine. J Coll Physician Surg Pak 2007;17(7):390-3.
Ahsan B, Shami Sh, Nasserii K, et al. Comparison of remifentanil - propofol with remifentanil - sodium thiopental for intubation without muscle relaxants. J Gorgan Univ Med Sci 2009;11(1):18-25.
Koay CK, Yoong CS, Kok P. A randomized trial comparing two laryngeal mask airway insertion techniques. Anaesth Intensive Care 2001;29(6):613-5.
Ghafoor HB, Afshan G, Kamal R. General Anesthesia with Laryngeal Mask Airway: Etomidate vs Propofol for Hemodynamic Stability. Open J Anesthesiol 2012;2(4):161-5.
Yeo KSJ, Kua SW, Teoh GS, et al. The use of thipentone/ propofol admixture for laryngeal mask airway insertion. Anaesth Intensive Care 2001;29(1):38-42.
Mohamed Amr Y, Amin SM. Comparison of two regimes of thiopental and propofol for I-gel supraglottic airway device insertion. Anesth Essays Res 2010;4(1):25-8.
Movafegh A, Akrami M, Mhrayyn A. Efficacy of lidocaine, propofol and dexamethasone on nausea and vomiting after orthopedic surgery (upper extremity). Tehran Univ Med Sci J 2004;5:351-6.
Khezri MB, Rashad F, Javadi A. Comparison of low-dose propofol and metoclopramide for prevention of nausea and vomiting after operation. J Birjand Univ Med Sci 2009;16(3):5-8.