Propofol for laryngeal mask airway insertion in children: Effect of two different doses

PURPOSE: To compare two different doses of propofol for laryngeal mask airway (LMA) insertion in children undergoing out-patient surgeries. BACKGROUND: Insertion of LMA just after anesthesia induction is facilitated using propofol. However, the optimal dose of this drug not determined yet as heavy doses may lead to severe complications, whereas lower doses may not be quite as effective. METHODS: In a double-blind randomized clinical trial, 120 children undergoing out-patient surgeries were recruited to receive intravenous propofol at a dose of either 2.5 mg/kg (group 1) or 3.5 mg/kg (group 2) for induction. Intravenous midazolam (0.03 mg/kg) and fentanyl (1 μg/kg) were used as pre-medication in all patients and anesthesia induction was initiated using lidocaine (1 mg/kg) prior to propofol administration. Hemodynamic changes, probable complications, quality of the established airway and number of attempts for LMA insertion were compared between two groups. RESULTS: There were no differences in systolic and diastolic blood pressure, heart rate, peripheral oxygen saturation and intraoperative complications between the groups (P>0.05). LMA insertion was successful at the first attempt in 55 (93.2%) and 54 (91.5%) cases in group 1 and group 2, respectively (P>0.05). The efficiency of the established airways was adequate in all the patients of both groups. CONCLUSION: It seems that propofol doses of 2.5 and 3.5 mg/kg are equally effective for LMA insertion following intravenous midazolam, fentanyl, and lidocaine.