The comparison of propofol combined with ketamine or fentanyl for laryngeal mask placement application in pediatric patients

Objective To investigate ideal combination of propofol combined with ketamine or fentanyl for laryngeal mask placement application in pediatric patients.Methods Sixty pediatric patients of ASA Ⅰ ～ Ⅱ undergoing elective surgery for laryngeal mask placement were randomly assigned into fentanyl group(group F,n = 30) and ketamine group(group K,n = 30).Anesthesia induction: After intravenous injection fentanyl 2 μg·kg-1(group F) or ketamine 0.5 mg·kg-1(group K),intravenous injection of propofol 3.5 mg· kg-1,and then laryngeal mask(LMA) was inserted.Blood pressure(BP) and heart rate(HR) at based values before LMA placement at 1,3,5 minutes after LMA insertion were recorded.Subjective grading of LMA placement of resistance open mouth and insert,swallowing,cough/sick,head and body movement,laryngospasm were recorded;the duration and morbidity of apnea after LMA placement were recorded;the success rates,additional propofol and endotracheal intubation number were also recorded.Results The incidence rate of resistance open mouth and insert,swallowing had no statistically significant differences between group F and group K.The incidence rate of cough/sick,body/head movement,apnea were 8% and 28%,64% and 76%,50% and 80% in group F and group K respectively.In group F and group K the incidences of apnea were 80% and 50% respectively.Compared with group F,the HR,systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MBP) in the same time is higher than those in group K.Conclusions Fentanyl(2 μg·kg-1) combined with propofol(3.5 mg·kg-1) can provide the better condition of LMA placement than ketamine(0.5 mg·kg-1) combined with propofol in pediatric patients.