A prospective, randomized, controlled trial study of comparison of two techniques for laryngeal mask airway insertion

Introduction: In this study we compared the use of an intravenous propofol/propofol auto-co-induction technique to propofol/midazolam for laryngeal mask insertion. We also studied the incidence of undesirable effects in relation to LIMA insertion. Methodology: In this prospective, randomized, controlled trial study, 60 adults belonging to ASA class 1 and 2 were randomly divided in three groups; Groupl - Saline-propofol; Group 2- Propofol-midazolam; Group 3-Propofol-propofol. The induction characteristics reviewing various parameters like the induction dose required, hemodynamic changes and the cost of induction were observed. I Hemodynamic variables including heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded at 2,4 and 6 minutes post induction. Results: We noticed a decrease in HR, SBP, and DBP & MAP in all 3 groups which was not statistically significant. The total induction dose of propofol in Group 2 (106.3 +/- 21.26 mg) and Group 3 (136.50 +/- 20.29 mg) was significantly lower than Group 1 (159.75 +/- 31.39 mg) but not statistically different between group 2 and 3. The total cost of induction was significantly reduced in the midazolam co-induction group i.e. Group 2. The number of patients suffering from apnea differed significantly between 3 groups i.e. 12 patients in Group 1,6 patients in Group 2 and 1 patient in Group 3. No significant difference was seen in 3 groups in incidence of hiccups, excitatory phenomenon or laryngospasm. Conclusion: Propofol co-induction (Group 2) and propofol auto co-induction is safe alternative to propofol induction and is more cost effective as they decrease the cost of induction. Midazolam co-induction is more economical than propofol auto co-induction.