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Dose of propofol required to insert the laryngeal mask airway in children
Insights
The Brain Laryngeal Mask Airway (LMA) is safely and effectively inserted after anesthesia induction with 3.5 mg.kg-1 propofol in children. Higher propofol doses significantly improved LMA insertion conditions.
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
- Airway Management
Background:
- Laryngeal Mask Airway (LMA) is a common supraglottic airway device.
- Propofol is widely used for induction of anesthesia in children.
- Optimizing LMA insertion conditions is crucial for patient safety and procedural efficiency.
Purpose of the Study:
- To evaluate the ease of insertion of the Brain Laryngeal Mask Airway (LMA) in children.
- To determine the optimal propofol dosage for LMA insertion following anesthesia induction.
- To assess the safety and efficacy of immediate LMA insertion after propofol administration.
Main Methods:
- A randomized controlled trial involving 60 healthy children aged 4-9 years.
- Patients received varying doses of propofol (2.5, 3, or 3.5 mg.kg-1) mixed with lignocaine.
- LMA insertion conditions were subjectively assessed as good, acceptable, unacceptable, or impossible.
Main Results:
- LMA insertion was successful in all participants.
- Good or acceptable insertion conditions were achieved in 35% (Group A), 70% (Group B), and 95% (Group C) of patients (P < 0.0001).
- No significant changes in heart rate or blood pressure were observed, indicating clinical insignificance.
Conclusions:
- Propofol at 3.5 mg.kg-1 provides optimal conditions for Brain LMA insertion in pediatric patients.
- Immediate LMA insertion following anesthesia induction with this dose is safe and effective.
- This study supports the use of higher propofol doses for improved LMA insertion success in children.
Abstract:
We have assessed the ease of insertion of the Brain Laryngeal Mask Airway (LMA) after induction of anaesthesia with propofol in 60 healthy unpremedicated children aged between four and nine years. Patients were randomly allocated into three groups: group A = propofol 2.5 mg.kg-1; group B = propofol 3 mg.kg-1 and group C = propofol 3.5 mg.kg-1. Propofol was mixed with lignocaine 0.5 mg.kg-1. Insertion conditions were assessed subjectively as good, acceptable, unacceptable or impossible. Insertion of the LMA was possible in all patients. Good and acceptable conditions were obtained in 35%, 70% and 95% in groups A, B, and C respectively (P < 0.0001). There was no statistically significant inter group variation in systolic and diastolic arterial pressure or in heart rate for five min after induction. All measured cardiovascular changes were considered to be clinically insignificant in healthy children. We conclude it is safe and effective to insert a LMA immediately after induction of anaesthesia with propofol 3.5 mg.kg-1.