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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 3, May - June 2019, Pages 697-704
 

Original Article

Comparative Evaluation of two Different Intravenous Doses of Midazolam to Aid the Insertion of LMA Classic as Adjuvants to Propofol Anaesthesia

Geetanjali Pushkarna1, Varun Pushkarna2, Preetveen Kaur3, Pankaj Sarangal4

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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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6319.1

Abstract

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.
 


Keywords : Laryngeal mask airway; Midazolam; Propofol
Corresponding Author : Geetanjali Pushkarna, Assistant professor in Department of Anaesthesia, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab 143501, India.