COMPARISON OF INHALATIONAL VITAL CAPACITY INDUCTION WITH SEVOFLURANE TO INTRAVENOUS INDUCTION WITH PROPOFOL FOR LARYNGEAL MASK AIRWAY INSERTION IN ADULTS: A RANDOMISED STUDY
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Keywords
Sevoflurane, Propofol, LMA, Vital Capacity Breath, Inhalational Induction, Airway Management
Abstract
Background: The selection of an anesthetic agent significantly influences airway management, patient comfort, and safety. While intravenous propofol remains a
popular choice due to its rapid onset and suppression of airway reflexes, it is associated with cardiovascular depression. Sevoflurane, via the vital capacity breath (VCB)
technique, has emerged as a promising alternative due to its non-irritant properties and stable hemodynamic profile.
Objective: To compare the efficacy of vital capacity induction with 8% sevoflurane versus intravenous 2 mg/kg propofol in terms of insertion conditions, onset time, and hemodynamic responses during laryngeal mask airway (LMA) placement in adult surgical patients.
Methods: A prospective randomized study was conducted on 104 patients (ASA I-II), undergoing elective surgeries under general anesthesia. Patients were randomized into Group S (sevoflurane) and Group P (propofol), each with 52 patients. Parameters assessed included time for eyelash reflex loss, LMA insertion time, jaw relaxation, ease of insertion, apnea incidence, patient movement, gagging, coughing, laryngospasm, and hemodynamic variables at various time points.
Results: Propofol provided faster induction (eyelash reflex loss: 44.13 ± 4.34s vs. 61.38
± 5.83s; p<0.001) and quicker LMA insertion (12.92 ± 3.84s vs. 19.06 ± 3.93s; p=0.002). However, it was associated with higher apnea incidence (5.8% vs. 1.9%). Sevoflurane maintained more stable hemodynamic parameters. Both agents provided comparable LMA insertion conditions.
Conclusion: Both sevoflurane via VCB and IV propofol are effective for LMA insertion. Sevoflurane offers greater hemodynamic stability with a slightly delayed induction, while propofol ensures rapid induction at the cost of respiratory depression.
References
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Dr. Kiran Kumar M
Senior Resident, Department of Anaesthesiology, Critical care and Pain, ESIC MC PGIMSR & MODEL HOSPITAL, Rajajinagar, Bengaluru
Dr. Lokesh S. B
Assistant Professor, Department of Anaesthesiology, Critical care and Pain, ESIC MC PGIMSR & MODEL HOSPITAL, Rajajinagar, Bengaluru
Dr. Kavyashree Patil
unior consultant, Department of Anaesthesiology, Sparsh Hospital, Infantry road, Bengaluru
Dr. Prakash S
Senior Resident, Department of Anaesthesiology, Critical Care and Pain, ESIC MC PGIMSR & MODEL HOSPITAL, Rajajinagar, Bengaluru