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GENERAL ARTICLES

Comparison of Sevoflurane with Propofol for Laryngeal Mask Airway Insertion in Adults

Lian Kah Ti, MMED^*, Mark Y. H. Chow, MMED, and Tat Leang Lee, MMED, FFARACS^*

*Department of Anaesthesia, National University Hospital; and Department of Anaesthesia and Surgical Intensive Care, Singapore General Hospital, Singapore

Address correspondence and reprints requests to Lian Kah Ti, MMed, Department of Anaesthesia, National University Hospital, 5 Lower Kent Ridge Rd., Singapore 119074, Republic of Singapore. Address e-mail to anatilk{at}nus.edu.sg

We performed a prospective, randomized, controlled trial to compare the quality and ease of laryngeal mask airway (LMA) insertion after either rapid inhaled sevoflurane or IV propofol induction of anesthesia. Seventy-six unpremedicated ASA physical status I or II patients were anesthetized with either a single vital capacity breath of sevoflurane 8% or IV propofol 3 mg/kg, which produced equally rapid loss of consciousness (40.5 ± 13.9 vs 37.7 ± 9.9 s; P > 0.05). The LMA was inserted more rapidly in patients in the propofol group (74 ± 29 vs 127 ± 35 s; P < 0.01) and required fewer attempts (1.2 vs 1.6; P < 0.05) than the sevoflurane group. There was a greater incidence of initially impossible mouth opening in the sevoflurane group (45% vs 21%; P < 0.05). Once mouth opening was possible, the degree of attenuation of laryngeal reflexes was similar. The overall incidence of complications related to LMA insertion, especially apnea (32% vs 0%; P < 0.01), was more frequent in the propofol group (82% vs 26%; P < 0.01). There were four failures of LMA insertion in the propofol group and none in the sevoflurane group. Both groups had stable hemodynamic profiles and good patient satisfaction. We conclude that sevoflurane vital capacity breath induction compares favorably with IV propofol induction for LMA insertion in adults. However, prolonged jaw tightness after the sevoflurane induction of anesthesia may delay LMA insertion.

Implications: In this randomized, controlled trial, we compared the ease of insertion of the laryngeal mask airway in adults after induction of anesthesia with either a sevoflurane vital capacity breath technique or propofol IV. We conclude that sevoflurane compares favorably with propofol, although prolonged jaw tightness may delay laryngeal mask airway insertion.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999