Comparison of Dexmedetomidine – Propofol and Clonidine – Propofol for ease of Insertion of Laryngeal Mask Airway
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 6
Abstract
Abstract: It is a common practice to use a Laryngeal mask for administration of anaesthetic and ventilation gases to patients. It has advantages over endotracheal tubes which are longer and seal the trachea below the vocal folds. However sometimes laryngeal mask airways can cause trauma to laryngeal walls. The aim is to compare the efficacy of Dexmedetomidine – Propofol combination and Clonidine – Propofol combination for LMAinsertion in terms of Ease of insertion and Haemodynamic responses to LMA insertion. The study was conducted in MGM Hospital 60 patients aged between 20 and 50 years belonging to ASA I-II category with MPG grade I and II who were scheduled for short elective surgeries. Patients were divided into 2 groups randomly: Dp (Dexmedetomidine) or Cp (Clonidine) with 30 patients in each group. After pre-oxygenation for 3 minutes with 100% O2 on mask, group Dp received 1µg/kg dexmedetomidine and group Cp received 1µg/kg of Clonidine diluted in 10ml normal saline respectively, i.v over 10 minutes. Thirty seconds later, patients were induced with intravenous injection of propofol 2.5mg/kg mixed with 1 ml of 2% lignocaine. 90 sec after propofol bolus, first attempt at insertion of LMA was made. If required, further increments of propofol 0.5mg/kg I.V were given every 30 seconds till loss of consciousness and loss of eyelash reflex. After insertion, cuff was inflated with recommended volume of air, and patient connected to breathing circuit. On comparing Post LMA, 1 min, 2mins, 3 mins mean heart rate to Pre LMA mean heart rate, in dexmedetomidine group there was not statistically significant difference (p > 0.05). We found a statistically better jaw relaxation in dexmedetomidine group compared toClonidine group. No patient in dexmedetomidine group had coughing but 6 patients (20%) had grade 2 of coughing and 1 patient (3.33%) had grade 4 of coughing in Clonidine group. 1 patient (3.33%) required two attempts at LMA insertion in dexmedetomidine group and 5 patients (16.67%) in Clonidine group required two attempts at LMA insertion. There was no statistically significant difference between the respiratory rates between both the groups. From our study we came to a conclusion that dexmedetomidine gives better insertionconditions and better attenuation of pressor response to LMA insertion compared to Clonidine in the given doses and that dexmedetomidine can be used with an advantage for LMA insertions in short surgical procedures. Keywords:Dexmedetomidine/Propofol, Clonidine/Propofol, Insertion of Laryngeal Mask Airway.
Authors and Affiliations
Shanthan Kumar Repalle, Rakam Kalyan
Keywords
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