Comparison of dexmedetomidine combined with propofol Vs fentanyl combined with propofol for laryngeal mask insertion

Background: Few studies have assessed adequacy of anaesthesia provided by propofol in combination with dexmedetomidine and propofol in combination with fentanyl for laryngeal mask airway (LMA) insertion for minor to moderate elective surgical procedures. Methods: Sixty patients admitted for lower abdominal and lower limb surgery were randomized into Group F (n=30) and Group D (n=30). Thirty seconds after the study drug (fentanyl1 µg/kg in Group F and dexmedetomidine 1 µg/kg in Group D diluted in 10 mL normal saline over 2 min) was administered, induction was done with i.v. propofol 2 mg/kg in both groups. Ninety seconds after propofol injection, jaw relaxation was assessed and LMA of appropriate size was inserted. If the first attempt failed, another attempt was tried after an additional dose of i.v. propofol (0.5 mg/kg). Haemodynamic parameters, namely, heart rate, systolic blood pressure (SBP), mean blood pressure (MBP), diastolic blood pressure (DBP), arterial oxygen saturation measured with pulse oximeter and respiratory rate were recorded before and at the end of 1st, 2nd, 3rd, 5th and 10th minutes after insertion of LMA. Results: Both the groups were comparable in age weight, sex, age wise distribution and insertion conditions. The reductions in SBP, DBP, MAP were greater in Group F (p < 0.001). More patients developed apnoea in Group F than in Group D (p < 0.05). Conclusions: Dexmedetomidine combined with propofol provides the same conditions for LMA insertion as fentanylpropofol combinations with advantage of better maintainance of haemodynamic parameters.