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Comparison of the anaesthetic requirement with target-controlled infusion of propofol to insert the laryngeal tube vs. the laryngeal mask

Published online by Cambridge University Press:  13 October 2005

P. Richebé ,
B. Rivalan ,
L. Baudouin ,
M. Sesay ,
F. Sztark ,
A.-M. Cros  and
P. Maurette
P. Richebé
Affiliation:
Centre Hospitalier et Universitaire de Bordeaux, Département d'Anesthésie et Réanimation III, Bordeaux Cedex, France
B. Rivalan
Affiliation:
Centre Hospitalier et Universitaire de Bordeaux, Département d'Anesthésie et Réanimation III, Bordeaux Cedex, France
L. Baudouin
Affiliation:
Centre Hospitalier et Universitaire de Bordeaux, Département d'Anesthésie et Réanimation III, Bordeaux Cedex, France
M. Sesay
Affiliation:
Centre Hospitalier et Universitaire de Bordeaux, Département d'Anesthésie et Réanimation III, Bordeaux Cedex, France
F. Sztark
Affiliation:
Centre Hospitalier et Universitaire de Bordeaux, Département d'Anesthésie et Réanimation I, Bordeaux Cedex, France
A.-M. Cros
Affiliation:
Centre Hospitalier et Universitaire de Bordeaux, Département d'Anesthésie et Réanimation IV, Bordeaux Cedex, France
P. Maurette
Affiliation:
Centre Hospitalier et Universitaire de Bordeaux, Département d'Anesthésie et Réanimation III, Bordeaux Cedex, France
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Summary

Background and objective: The target effect-site concentration of propofol to insert a laryngeal mask airway was recently reported as almost 5 μg mL−1. The present study aimed to determine the target effect-site concentration with target-controlled infusion of propofol to place classical larnygeal mask airway or current laryngeal tube in adult patients. Methods: We included 40 patients scheduled for short gynaecological and radiological procedures under general anaesthesia in a randomized, double-blind manner using the Dixon's up-and-down statistical method. Monitoring included standard cardiorespiratory monitors, and bispectral index monitoring was used for all patients. Anaesthesia was conducted with a target-controlled infusion system: Diprifusor™. The initial target plasma concentration of propofol was 5 μg mL−1, and was changed stepwise by 0.5 μg mL−1 increments according to Dixon's up-and-down method. Criteria for acceptable insertion were: Muzi's score ≤2, and mean arterial blood pressure, heart rate or bispectral index variation <20% the baseline values.Results: Target effect-site concentration of propofol required to insert laryngeal tube was 6.3 ± 0.3 μg mL−1 with Dixon method and ED50 was 6.1 μg mL−1 (5.9–6.4) with logistic regression method. In the case of larnygeal mask airway they were 7.3 ± 0.2 μg mL−1 (Dixon method) and 7.3 μg mL−1 (7.1–7.5; with logistic regression) respectively (P < 0.05). ED95 (logistic regression) was 6.8 μg mL−1 (5.9–7.6) for laryngeal tube and 7.7 μg mL−1 (7.3–8.0) for larnygeal mask airway (P < 0.05). Haemodynamic incidents were 55% in the larnygeal mask airway group vs. 30% in the laryngeal tube group (P < 0.05). Conclusions: The target effect-site concentration of propofol for insertion of laryngeal tube was lower than for larnygeal mask airway (P < 0.05), with a consequent reduction of the propofol induced haemodynamic side-effects.

Keywords

LARYNGEAL MASKPROPOFOLANAESTHESIA INTRAVENOUS
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 11 , November 2005 , pp. 858 - 863
Copyright
© 2005 European Society of Anaesthesiology

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