Original Article

Comparison of Propofol and Sevoflurane for Laryngeal Mask Airway Insertion in Elderly Patients

Authors: GuiQian Shao, MD, GuoHua Zhang, MD

Abstract

Background: Sevoflurane and propofol have been widely used for anesthesia induction. This study compared the efficacies of sevoflurane and propofol inductions for laryngeal mask airway (LMA) insertion in elderly patients.


Methods: Ninety patients, aged 60 or more, received anesthesia induction with propofol and with sevoflurane 8% using the vital capacity breath (VCB) or tidal volume breath (TVB) techniques. Hemodynamic changes, induction time, complications, and the quality and ease of LMA insertion were observed.


Results: LMA was inserted most, less or least rapidly with propofol (89 ± 28 s), sevoflurane 8% using the VCB (163 ± 34 s) or TVB (205 ± 44 s) techniques, respectively. Anesthesia induction with propofol or sevoflurane 8% using the VCB technique produced either more frequent apnea or greater reduction in mean blood pressure than with sevoflurane 8% using the TVB technique.


Conclusions: Sevoflurane 8% using the TVB technique provides a smoother induction with a stable hemodynamic profile, less apnea and technical demand, but requiring longer time for LMA insertion in unpremedicated elderly patients.


Key Points


* Anesthesia inductions with propofol and with sevoflurane 8% using the vital capacity breath (VCB) or tidal volume breath (TVB) techniques can all provide clinically accepted conditions for laryngeal mask airway (LMA) insertion in elderly patients.


* Propofol induction offered more rapid LMA insertion with fewer attempts, but also greater reduction in mean blood pressure and more frequent apnea, compared with the two sevoflurane induction methods.


* Although sevoflurane 8% plus VCB technique took less time for insertion of LMA, it resulted in more pronounced hemodynamic changes and required extra patient cooperation and anesthesia circuit priming as compared to sevoflurane 8% plus TVB technique.


* Sevoflurane 8% plus TVB technique was able to provide smoother anesthesia induction for LMA insertion in elderly patients with fewer untoward events at the cost of longer induction time.

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