ABSTRACT
Conditions for insertion of a laryngeal mask airway in 90 unpremedicated adult were patients were assessed in a randomised, single-blinded trial. Each patient received fentanyl 1 microgram.kg-1 and thiopentone 5 mg.kg-1, and this was preceded either by lignocaine 0.5 mg.kg-1 intravenously (group 1), lignocaine 1.5 mg.kg-1 intravenously (group 2) or 40 mg of topical lignocaine spray to the posterior pharyngeal wall (group 3). Conditions for laryngeal mask airway insertion were recorded. The group receiving topical lignocaine had a lower incidence of laryngospasm (p < 0.05), required fewer attempts for successful insertion of the laryngeal mask (p < 0.05) and coughed or gagged less frequently than either group receiving lignocaine intravenously (p > 0.05). Overall, the conditions for laryngeal mask airway insertion were better in the topical group (p < 0.05). There were no significant differences in haemodynamic response and apnoea between the three groups. Topical lignocaine spray prior to thiopentone provides conditions for insertion of a laryngeal mask that are superior to those provided by lignocaine and thiopentone intravenously.
Subject(s)
Anesthesia, Local , Laryngeal Masks , Lidocaine/administration & dosage , Thiopental/administration & dosage , Administration, Topical , Adolescent , Adult , Aged , Female , Humans , Laryngismus/prevention & control , Male , Middle Aged , Single-Blind MethodABSTRACT
We assessed conditions for insertion of a laryngeal mask airway in 90 unpremedicated adult patients who received either thiopentone 5 mg.kg-1 preceded by 40 mg of topical lignocaine spray to the posterior pharyngeal wall or propofol 2.5 mg.kg-1 alone in a randomised, single-blinded trial. All patients received fentanyl 1 microgram.kg-1. Gagging, coughing and laryngospasm following laryngeal mask insertion were graded and haemodynamic data and apnoea times were recorded. There were no significant differences between the two groups with regard to the incidence of gagging, coughing and laryngospasm, but the apnoea time was significantly less in the thiopentone group (p < 0.005). The decrease in systolic and diastolic blood pressure, following induction and the insertion of a laryngeal mask with propofol was significantly greater than following thiopentone (p < 0.05--systolic, p < 0.01--diastolic). We conclude that thiopentone preceded by topical lignocaine spray provides conditions for insertion of a laryngeal mask equal to those of propofol, with more haemodynamic stability and a shorter period of apnoea.
Subject(s)
Anesthetics, Intravenous , Anesthetics, Local , Laryngeal Masks , Lidocaine , Thiopental , Adolescent , Adult , Female , Gagging/drug effects , Hemodynamics/drug effects , Humans , Laryngeal Masks/adverse effects , Male , Middle Aged , Propofol , Single-Blind MethodSubject(s)
Analgesia, Patient-Controlled/instrumentation , Infusion Pumps , Equipment Failure , Female , Humans , Middle AgedABSTRACT
We have compared two groups (n = 22) of unpremedicated patients to determine if the pain caused by injection of propofol could be modified by alfentanil. In group I, alfentanil 1 mg was given as a bolus i.v. injection 15 s before administration of propofol i.v., while group II received saline. Propofol was given in 20-mg increments every 4 s. All injections were given through the same i.v. cannula on the dorsum of one hand. We found that alfentanil pretreatment reduced pain on injection of propofol (P = 0.001).