Propofol or sevoflurane for laryngeal mask airway insertion

Purpose: Sevoflurane is a volatile anesthetic agent, which combines rapid. smooth inhalational induction of anesthesia with rapid recovery, making it particularly suitable for day case anesthesia, The laryngeal mask airway is often also used in ambulatory anesthesia, with intravenous propofol being the agent of choice for its insertion. Our objective was to compare the con ditions for laryngeal mask airway (LMA) insertion obtained by modified vita l capacity breath sevoflurane inhalational induction of anesthesia with pro pofol intravenous induction. Methods: Eighty-eight patients, aged 18-65 yt; ASA I-II, undergoing general anesthesia for elective surgery were randomized into two groups in a prosp ective, single-blind study Patients in Group P (n=44) received 2.5 mg.kg/pr opofol iv and in Group S (n=44) received sevoflurane 8% in nitrous oxide 50 % and oxygen. Ventilation was not assisted, Laryngeal mask airway insertion was attempted at one minute intervals from loss of both verbal response an d eyelash reflex, by an anesthesiologist unaware of the induction technique . Complications, such as coughing and head movement, were also noted at eac h attempt, Results: Mean time to successful LMA insertion was 1.3 (1-3) min in P and 2 .2(1-3) min in S, P < 0.05. Eleven patients in Group Fl (25%) required addi tional propofol compared with four (99%) in S, P < 0.05. Incidence of compl ications was similar in both groups and by 3 min, LMA was successfully inse rted in all patients, Conclusion: Modified vital capacity breath inhalational induction with sevo flurane 8% is efficient for LMA insertion in most cases, but takes slightly longer than propofol.