Laryngeal mask insertion using thiopental and low dose atracurium: a comparison with propofol

Purpose: To compare the laryngeal mask airway (LMA) insertion conditions produced by propofol and a thiopental - low dose atracurium combination. Methods: In a randomized controlled double blind study, 120 premedicated patients were allocated into four groups. After pre-oxygenation, anesthesia was induced as follows: 1 mu g.kg(-1) fentanyl, 2.5 mg.kg(-1) propofol (group I); 1 mu g.kg(-1) fentanyl, 5 mg.kg(-1) thiopental (group II); 1 mu g.kg(-1) fentanyl, 5 mg.kg(-1) thiopental, 0.05 mg.kg(-1) or 0.1 mg.kg(-1) atracurium (groups III and IV respectively). The LMA was inserted by a blinded anesthesiologist who also assessed the following insertion conditions on a three point scale; jaw relaxation, biting, gagging, coughing, presence of laryngospasm, adequacy of airway patency, number of attempts at insertion and overall insertion conditions. Results: There was no difference in insertion conditions between groups I, III and IV: Group II produced the wont overall conditions (P < 0.05). There were no differences in hemodynamic changes and apnea times between all four groups. Conclusion: The combination of fentanyl-thiopental with low dose atracurium (0.05 or 0.1 mg.kg(-1)) provided conditions comparable with those of propofol for LMA insertion.