Ease of Laryngeal Mask Airway insertion in Nigerian adults: propofol alone vs propofol combined with low dose suxamethonium

Abstract

Background: Inadequate anaesthesia during Laryngeal Mask Airway (LMA) insertion may make correct positioning difficult or even impossible.

Objective: This prospective study was designed to compare the ease of LMA insertion in patients who received propofol alone and patients who received a combination of propofol with low dose (0.1 mg/kg) suxamethonium.

Methods: Eighty ASA I and II consenting patients aged 18 to 60 years undergoing elective procedures under general anaesthesia and spontaneous ventilation were recruited and randomly allocated into two groups with each receiving either 5 mls of 0.9% saline (group P) or 0.1 mg/kg suxamethonium, made up to 5 mls (group S), 30 seconds post induction with intravenous (iv) propofol 2.5 mg/kg delivered over 30 seconds. The overall insertion conditions (scored from grade of jaw relaxation, ease of insertion, severity of airway response in terms of coughing, gagging, laryngospasm and patient movement) during first attempt of LMA insertion and the number of attempts made were then accessed. The number of attempts before successful LMA insertion as well as incidence and duration of apnoea post induction were recorded.

Results: Excellent overall insertion condition occurred in 40% of patients in group S compared to 15% in group P, satisfactory in 30% of patients in group S compared to 35% in group P, and poor in 30% of patients in group S compared to 50% of patients in group P.

Conclusion: The combination of propofol plus low dose suxamethonium for LMA insertion was found to provide better grades of overall insertion condition. The number of attempts before successful insertion was however comparable.