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Indian Journal of Anesthesia and Analgesia

Volume  5, Issue 12, December 2018, Pages 2084-2093


Original Article

Use of Low Dose Suxamethonium to Facilitate Laryngeal Mask Insertion Under Etomidate Anesthesia
Nandipati Sushma1, Venkata R.K. Kodali2, Harish B. Ravulapalli3
1Assistant Professor, Department of Anesthesia, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu 600044, India. 2Associate Professor, Department of Anesthesia, Sri Ramachandra University, Chennai, Tamil Nadu 600116, India. 3Associate Professor, Department of Anesthesia, Narayana Medical College and Hospital, Nellore, Andhra Pradesh 524003, India.
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  Context: Endotracheal intubation is a routine since the discovery of general anesthesia. Passage of endotracheal tube is not without morbidity, dental damage and sore throat being the commonest and serious complications. An attempt to solve this problem lead to the invention of many oropharyngeal devices. For their successful placement in the larynx, the technique of insertion along with proper insertion conditions­ plane of anesthesia and no response from patient are required. Aims: To assess patients response for laryngeal mask airway insertion while maintaining hemodynamic stability using appropriate dose of induction agent. Settings and Design: A comparative randomised prospective double blind controlled study. Methods and Material: Sixty patients who underwent surgery under general anesthesia with laryngeal mask airway were randomized and divided into three groups (20 in each group): Group NS­patients receiving Etomidate plus normal saline, Group S1­patients receiving Etomidate plus 0.25mg/kg Suxamethonium, Group S2­ patients receiving Etomidate plus 0.5mg/kg Suxamethonium. We compared parameters like heart rate, mean arterial pressure and response from patient while inserting laryngeal mask airway ­ jaw relaxation, coughing, gagging, swallowing, movement of head and limbs, laryngospasm; among all three groups. Statistical analysis used: Pearson ChiSquare test to compare success rate between the groups for all the parameters assessed. Variables were analysed using One way ANNOVA test. Results: Low dose of Suxamethonium when combined with Etomidate provides better conditions for laryngeal mask airway insertion than etomidate alone. Conclusions: Intravenous 0.5mg/kg Suxamethonium produces better insertion conditions for Laryngeal Mask Airway than intravenous 0.25mg/kg Suxamethonium. 

Keywords: Etomidate; General Anaesthesia; Laryngeal Mask Airway; Laryngospasm; Swalloing; Suxamethonium. 

Corresponding Author : Venkata R.K. Kodali, Associate Professor, Department of Anesthesia, Sri Ramachandra University, Chennai, Tamil Nadu 600116, India.