Alfentanil co-induction for laryngeal mask insertion

Area of Science:

• Anesthesiology
• Pharmacology

Background:

• Propofol is a common anesthetic induction agent.
• Laryngeal mask airway (LMA) insertion requires optimal patient conditions for success.
• Alfentanil is an opioid analgesic that may improve anesthetic conditions.

Purpose of the Study:

• To evaluate the effect of two alfentanil doses (5 and 10 micrograms.kg-1) combined with propofol on LMA insertion.
• To compare the ease of insertion, airway patency, and success rate of LMA insertion.
• To assess hemodynamic changes associated with alfentanil and propofol administration.

Main Methods:

• A randomized study involving 150 ASA 1 and 2 patients.
• Patients received propofol alone (Group P), or propofol with 5 micrograms.kg-1 (Group A5) or 10 micrograms.kg-1 (Group A10) of alfentanil.
• LMA insertion conditions, success rates, apnea times, and hemodynamic parameters were recorded.

Main Results:

• Alfentanil addition significantly improved LMA insertion ease and airway patency.
• First-attempt LMA insertion success rates were higher with alfentanil (A5: 96%, A10: 94%) compared to propofol alone (58%).
• The 10 micrograms.kg-1 alfentanil dose caused significant decreases in mean arterial pressure and heart rate.

Conclusions:

• Pretreatment with 5 micrograms.kg-1 intravenous alfentanil before propofol provides excellent conditions for LMA insertion.
• This dose combination results in a high success rate for LMA insertion with minimal adverse hemodynamic effects.
• Alfentanil at 10 micrograms.kg-1 may lead to undesirable hemodynamic changes.