Abstract:
In a prospective, randomized study, we investigated the incidence of successful insertion of laryngeal mask airway (LMA) at the first attempt and the incidence of side effects after LMA insertion using the combination of sevoflurane and propofol as compared with either sevoflurane or propofol alone for induction of anesthesia. Eighty-three unpremedicated ASA physical status I-II patients were anesthetized with a single vital capacity breath (VCB) of sevoflurane 8percent supplemented with IV propofol 1.5 mg-kg, a single VCB of sevoflurane 8percent, or IV propofol 3 mg-kg. The coinduction technique was associated with the most frequent incidence of successful LMA insertion at the first attempt (93.5percent) than either sevoflurane alone (46percent) or propofol alone (61.5percent) (P 0.001). Propofol-induced induction of anesthesia allowed the fastest insertion of LMA and was associated with the least frequent incidence of postoperative nausea and vomiting. However, this advantage of propofol was offset by a frequent incidence of pain on injection (69percent) and the occurrence of movements during insertion of the LMA (50percent in the propofol group versus 19percent and 26percent in the sevoflurane and sevoflurane-propofol groups, respectively; P 0.05), as well as a more frequent incidence of apnea (84percent in the propofol group versus 7percent and 16percent in the sevoflurane and sevoflurane-propofol groups, respectively; P 0.001). The report shows that induction of anesthesia with sevoflurane-propofol combined provides a frequent incidence of successful LMA insertion at the first attempt that is associated with an infrequent incidence of apnea. © 2005 by the International Anesthesia Research Society.