Low dose of remifentanil in facilitation of Insertion of Laryngeal mask airway

Objective: To evaluate the effect of injection of remifentanil with propofol in decreasing the undesirable anesthetic airway responses such as coughing and gagging. Methods: We performed a randomized double-blind study from October 2003 to May 2004, in Emam Hospital in Tabriz, Iran, to compare the condition during insertion of LMA in 90 patients with ASA classes I and II, in 3 groups. Group R-1 received 0.25 mu g/kg remifentaniel and 2.5 mg/kg propofol, Group R-2 0.5 mu g/kg remifentanil and 2.5 mg/kg propofol, and Group P normal saline and 2.5 mg/kg propofol. Hemodynamic changes, apneic time, condition of insertion and airway patency were compared in these groups. Results: Remifentanil significantly improved the condition of insertion in-group R-1: 80.33% and group R-2: 90.6% in comparison with group P 40%. Hemodynamic changes in-group R-1 was less than R-2. Patients in-group R-1 were apneic for a mean time of 1.75 +/- 0.9 min as compared with 2.35 +/- 1.3 min in-group R-2. Conclusion: Administration of 0.25-mu g/kg remifentanil with 2.5 mg/kg propofol caused less hemodynamic changes and provided excellent condition for insertion of the LMA.