1,3,4Assistant Professor, Department of Anaesthesia, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab Punjab 143501, India. 2Consultant Critical Care, Fortis Escorts Hospital, Amritsar, Punjab 143004, India.
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Background: Propofol is a widely accepted medication for the uccessful insertion of laryngeal mask airway, but as a sole induction agent, it has a very low success rate. A number of co-induction agents have been used with propofol to increase the success rate of LMA insertion. Aim and Objectives: To evaluate the efficacy of two different doses of midazolam i.e. 0.05 mg/kg and 0.08 mg/kg intravenously when used with propofol versus propofol alone for LMA insertion. To find the appropriate dose of midazolam that provides ideal condition and maximum haemodynamic stability. Material & Methods: 75 adult patients of ASA I & II grade randomly divided into 3 groups. Group P: Propofol + Saline Group PM1: Midazolam 0.05 mg/kg 3 minutes before propofol + Propofol Group PM2: Midazolam 0.08 mg/kg 3 minutes before propofol + Propofol. LMA insertion attempted 1 minute after the administration of Propofol. Total dose of propofol used, the insertion conditions and haemodynamic changes were noted. Results: There was no statistical difference in demographic profile. Haemodynamically patients were more stable in group PM1 & PM2 than in group P. Dose of propofol used in PM2 (2.05+0.21 in mg/kg) & PM1 (2.38+0.21) was less than in Group P (2.84 mg/kg). 100% success rate in LMA insertion was observed in group PM1 & PM2 in first attempt whereas it was 80% in group P. 88% in group PM2, 60% in group PM1 & only 32% patients in group P had excellent insertion conditions. Conclusion: Propofol as a sole agent does not provide LMA insertion conditions. Midazolam when used with propofol provides adequate conditions for LMA insertion in a dose dependent manner.
Corresponding Author : Geetanjali Pushkarna, Assistant professor in Department of Anaesthesia, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab 143501, India.