Background
Laryngeal mask airway (LMA) has gained wide acceptance for airway management especially in day case surgery. Although propofol is known to blunt laryngeal reflexes, smooth and successful insertion of LMA requires a proper mouth opening to minimize airway reflexes such as gagging, coughing, and laryngospasm. The concurrent use of mini‐dose muscle relaxant with propofol could reduce the occurrence of airway reflexes and increase the success rate of LMA insertion.
Aim of the study
The aim of this study is to evaluate the effect of minidose atracurium and succinylcholine, to facilitate LMA insertion and which is better of them to achieve more satisfaction and less complications following induction of anesthesia with propofol, in day case surgery patients.
Patients and methods
This prospective, randomized, controlled, double-blind study was done on 90 healthy patients with American Society of Anesthesiologist physical status I or II, scheduled for elective surgery of less than 30 min under general anesthesia through LMA. These 90 patients were randomized by computer-generated and sealed opaque envelope method into three equal groups, according to the muscle relaxant given, with 30 patients (= 30) each, after the induction of anesthesia with fentanyl.
Results
The result of this study reveals that the first attempt in LMA insertion was successful in up to 27 (90%) patients in group S, whereas in only 23 (83.3%) patients in group A and 16 (60.0%) patients in group C. The difference was statistically significant (<0.001).
Conclusion
The concurrent use of minidose muscle relaxant with propofol and fentanyl significantly reduces the occurrence of airway reflexes, increases the success rate of LMA insertion, and decreases the incidence of postoperative sore throat. However, minidose of succinylcholine has a far better effect than minidose of atracurium with significant postoperative myalgia.