Effect of thiopentone with Lidocaine versus propofol for laryngeal mask airway insertion among adult patients undergoing elective surgery. Observational prospective cohort study
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Date
2019-06
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Addis Abeba University
Abstract
Background: Laryngeal mask airway is a simple supra-laryngeal device which is used to
establish and maintain air way. Maintaining airway is maintaining patient’s oxygenation and
ventilation which is vital in anesthesia practice and for patient’s life. Propofol is the most
common induction agent for LMA insertion but has side effects on cardiovascular and
respiratory systems. And it is not available in all countries.
Objective: To compare effects of Thiopentone with Lidocaine versus propofol for LMA
insertion for elective surgical patients at Minilik II hospital, Addis Ababa, Ethiopia from
December1, 2018 to April,30, 2019.
Methods: An institutional based observational prospective cohort study was conducted on eighty
eight eligible adult patients at Minilik II referral hospital from December, 2018 to April30, 2019.
The study participants were allocated in to Thiopentone-Lidocaine and propofol group. T-L
group (n =44) and P group (n =44). Data was entered in to Epi info version 7 software by
investigator and transported to SPSS version 23 program for analysis. Normality of the data was
checked by Shapiro wilk test and histogram. Independent t- test was used to determine the mean
differences between two groups. For non-parametric tests Chi square test was used. And when
appropriate fisher exact test was used. Those variables with p-value < 0.05 were considered as
statistically significant.
Results: The overall insertion score was comparable in both the groups. Excellent insertion score
was 33(75%) and 36(81.8%) in T-L and P group respectively. Satisfactory was 9(20.5%) in T-L
group and 8(18.8%) in P group. (p=0.34). A significant fall in mean arterial pressure was noted
in Propofol group at 1,2and 3 minutes following LMA insertion. At 1 min after LMA insertion it
was (84.61±9.8) vs (72.25 ±11.16), p<0.000,At 2 min (81.14± 10.43) vs (75.32± 12.15)
p<0.01,At 3 min (83.66± 9.24) vs (77.2± 10.98) p<0.004.A significant apnea time was also
observed in group P. (p<0.02), There was no significant difference in HR and SpO2 . 30.54 ET
Birr cost was reduced in T-L group than propofol group per case.
Conclusion and recommendation: Thiopentone with 2% IV Lidocaine is alternative for
insertion of LMA to propofol, with better hemodynamic stability and cost effectiveness. We
recommend that use of T-L induction of anesthesia for LMA for adult patients.
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Keywords
Thiopentone, IV Lidocaine, Propofol, LMA