RANDOMIZED DOUBLE BLIND COMPARISON OF KETAMINE - PROPOFOL AND FENTANYL - PROPOFOL FOR THE INSERTION OF LARYNGEAL MASK AIRWAY IN CHILDREN

DR AKILA KALIANNAN; DR BHASKAR MANOHAR

Volume : VII, Issue : II, February - 2018

RANDOMIZED DOUBLE BLIND COMPARISON OF KETAMINE - PROPOFOL AND FENTANYL - PROPOFOL FOR THE INSERTION OF LARYNGEAL MASK AIRWAY IN CHILDREN

Dr Akila Kaliannan, Dr Bhaskar Manohar

Abstract :

Background: Laryngeal Mask Airway started gaining popularity as an alternative to endotracheal intubation as well as facemask because it causes less hemodynamic changes, associated with negligible raise in intraocular pressure after inserting LMA, causes decreased incidence of sore throat and also frees the hands of the anaesthesiologist to perform other important tasks during the surgical procedures

Methods: Study design: Prospective, randomized, double blinded, comparative study

Setting: This study was conducted in the day care surgery theatre, Institute of

Child Health and Hospital for Children, an attached institution of Madras

Medical College over a period of three months.

Results: 1. The incidence of head and limb movements was less in Group Propofol +

Fentanyl compared to Group Propofol+ Ketamine with p value of 0.0148

2. Coughing or gagging was seen in 2.86% of both the groups.

3. Resistance to insertion was statistically significant with p value of 0.0268

showing more in Propofol + Ketamine group.

4. There was no statistical significance in the occurrence of restricted mouth

opening, restriction to LMA insertion and occurrence of swallowing

between the two groups.

5. Laryngospasm was absent in either groups.

6. Fentanyl group showed the incidence of more apnoea compared to

Ketamine group.

7. The heart rate (HR0, systolic blood pressure(SBP), diastolic blood

pressure(DBP) and mean arterial pressure(MAP) were statistically more

with Ketamine group than Fentanyl group.

Conclusions: co-induction with Fentanyl (2μg/kg) prior to Propofol (2.5 mg/kg) for insertion of Laryngeal Mask Airway in children provided better insertion conditions and minimal alteration in haemodynamic parameters than co-induction with Ketamine (0.5 mg/kg) and Propofol (2.5 mg/kg)..