The Effectiveness of Propofol Versus Inhalational Anesthetics in Preventing Adverse Events Following Deep Laryngeal Mask Airway Removal in Pediatric Patients Undergoing Ophthalmic Surgery, A Prospective Cohort Study
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Date
2023-06
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Addis Ababa University
Abstract
Airway manipulation in a light plane of anesthesia when removing airway device is associated with airway reflex like coughing causing increased heart rate, elevated blood pressure and ultimately, a rise in intra ocular pressure which is undesirable in ophthalmic surgical procedures. Propofol reduce airway reflex and are used for deep LMA removal. In the past the respective advantages and dis advantage of using Propofol for airway device removal have led to conflicting results.
Objective: To compare the effectiveness of Propofol versus inhalational anesthetics in preventing adverse events following deep LMA removal for pediatric patients undergoing ophthalmic surgery at selected governmental hospitals in Addis Ababa, Ethiopia from January 2023 to April 2023.
Methods: In this multi-center prospective cohort study 110 American Society of Anesthesiologists (ASA) physical status I and II pediatric (aged 1-8 year) patients who underwent ophthalmic surgery under general anesthesia with laryngeal mask airway, recruited by a systemic random sampling technique were included. Study participants were grouped as group P if anesthesia providers decreased inhalational to MAC awake and administered Propofol (0.5-1mg/kg) one minute before LMA removal and as group I if the anesthesia provider discontinued inhalational and removed LMA immediately after. Airway adverse events, hemodynamic changes and emergence duration was recorded. Data was analyzed by using SPSS version 26. Normality of the data was checked using Shapiro-Wilk test and analyzed using student t test for normally distributed data and chi-square test for categoricldata. Non-parametric data was analyzed using Mann –Whitney U test and p-value less than 0.05 was considered as statistically significant.
Result: comparison of data from Propofol with inhalational group and inhalational alone group using chi square showed that the incidence of airway related adverse events was significantly lower in group P (38.2%) than group I (58.2%), p< 0.05.There was no significant difference in hemodynamic changes and emergence duration (p>0.05) between the two groups.
Conclusions and Recommendation: We conclude that adding Small dose Propofol (0.5-1mg/kg) to inhalational MAC awake 1minute before LMA removal prevents adverse events following LMA removal in pediatric ophthalmic surgery. We recommend anesthetisis to add 0.5-1mg/kg of propofol to inhalational MAC awake one minute before LMA removal to prevent adverse events following ophthalmic procedures. We also recommend further randomized control to avoid bias.
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The Effectiveness of Propofol Versus Inhalational Anesthetics