Sengupta Janmejoy, Sengupta Mohua, Nag Tulsi
Department of Anesthesiology, Kali Pradip Choudhury Medical College and Hospital, Kolkata, India.
Ann Afr Med. 2014 Jul-Sep;13(3):124-9. doi: 10.4103/1596-3519.134405.
Development of endotracheal intubation to avoid deleterious effect on hemodynamic responses occurring during laryngoscopy and intubation compelled researchers to venture into alternative measures of airway management with subtle hemodynamic responses. This study was carried out to compare the conditions for laryngeal mask airways LMA insertion with widely used intravenous induction agents, thiopentone sodium and propofol, and also to compare the undesired responses occurring during LMA insertion with them.
The study was prospective, randomized, and double blind. All patients selected were randomly allocated into two groups: Group 1 (propofol) and group II (thiopentone). Preinduction heart rate and blood pressure were recorded. Sixty healthy adult patients of either sex belonging to age group of 20-60 years and ASA grade I or II, to undergo surgery less than 1 h, were selected for the study-Patients were randomly allocated in two groups, 30 in each group. Premedication with midazolam 0.04 mg/kg and fentanyl 2 mg/kg done in both groups. Thereafter, group 1 was induced with 2 mg/kg of propofol and group 2 with 5 mg/kg of thiopentone sodium.
The study revealed that, ease of insertion of LMA, was statistically significantly greater in group 1 when compared with group 2 (P 0.05). The time required for successful insertion of LMA was lesser in group 1 patients (53.8 ± 7.77 s) than in group 2 patients (84.7 ± 16.54 s) (P 0.001).
Severity of undesired responses were more in group 2, as incremental boluses of respective induction agents were required in 20% patients in thiopentone group compared to only 6% patients in propofol group and 13% of patients in thiopentone group required rescue succinylcholine.
气管插管的发展是为了避免喉镜检查和插管过程中对血流动力学反应产生有害影响，这促使研究人员探索具有轻微血流动力学反应的气道管理替代措施。本研究旨在比较喉罩气道（LMA）插入条件与广泛使用的静脉诱导剂硫喷妥钠和丙泊酚的差异，并比较LMA插入过程中与它们相关的不良反应。
本研究为前瞻性、随机、双盲研究。所有入选患者随机分为两组：第1组（丙泊酚组）和第2组（硫喷妥钠组）。记录诱导前心率和血压。选择60例年龄在20 - 60岁、ASA分级为I或II级、手术时间小于1小时的成年健康患者进行研究。患者随机分为两组，每组30例。两组均给予咪达唑仑0.04mg/kg和芬太尼2mg/kg进行术前用药。此后，第1组用2mg/kg丙泊酚诱导，第2组用5mg/kg硫喷妥钠诱导。
研究显示，与第2组相比，第1组LMA插入的 ease of insertion在统计学上显著更高（P < 0.05）。第1组患者成功插入LMA所需时间（53.8 ± 7.77秒）比第2组患者（84.7 ± 16.54秒）少（P < 0.001）。
第2组不良反应的严重程度更高，因为硫喷妥钠组20%的患者需要追加各自的诱导剂推注，而丙泊酚组仅6%的患者需要，并且硫喷妥钠组13%的患者需要抢救性使用琥珀酰胆碱。
