Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-27T10:27:38.606Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access

Extract

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Dorges V, Ocker H, Wenzel V, Schmucker P. The laryngeal tube: a new simple airway device. Anesth Analg 2000; 90: 1220–1222.Google Scholar
Asai T, Kawashima A, Hidaka I, Kawachi S. Laryngeal tube: its use for controlled ventilation. Masui 2001; 50: 1340–1341.Google Scholar
Brimacombe J. The advantages of the LMA over the tracheal tube or face mask: a meta-analysis. Can J Anaesth 1995; 42: 1017–1023.Google Scholar
Brain AI, McGhee TD, McAteer EJ, Thomas A, Abu-Saad MA, Bushman JA. The laryngeal mask airway. Development and preliminary trials of a new type of airway. Anaesthesia 1985; 40: 356–361.Google Scholar
Asai T, Murao K, Shingu K. Efficacy of the laryngeal tube during intermittent positive-pressure ventilation. Anaesthesia 2000; 55: 1099–1102.Google Scholar
Gaitini LA, Vaida SJ, Somri M et al. An evaluation of the laryngeal tube during general anesthesia using mechanical ventilation. Anesth Analg 2003; 96: 1750–1755.Google Scholar
Cook TM, McCormick B, Asai T. Randomized comparison of laryngeal tube with classic laryngeal mask airway for anaesthesia with controlled ventilation. Br J Anaesth 2003; 91: 373–378.Google Scholar
Devitt J. The laryngeal mask airway and positive-pressure ventilation. Anesthesiology 1994; 80: 550–555.Google Scholar
Keller C, Sparr HJ, Brimacombe JR. Positive pressure ventilation with the laryngeal mask airway in non-paralysed patients: comparison of sevoflurane and propofol maintenance techniques. Br J Anaesth 1998; 80: 332–336.Google Scholar
Danks RR, Danks B. Laryngeal mask airway: review of indications and use. J Emerg Nurs 2004; 30: 30–35.Google Scholar
Agro F, Cataldo R, Alfano A, Galli B. A new prototype for airway management in an emergency: the laryngeal tube. Resuscitation 1999; 41: 284–286.Google Scholar
Asai T. Use of the laryngeal tube (R) in a patient with an unstable neck. Can J Anaesth 2002; 49: 642–643.Google Scholar
Asai T, Hidaka I, Kawachi S. Efficacy of the laryngeal tube by inexperienced personnel. Resuscitation 2002; 55: 171–175.Google Scholar
Asai T, Kawashima A, Hidaka I, Kawachi S. The laryngeal tube compared with the laryngeal mask: insertion, gas leak pressure and gastric insufflation. Br J Anaesth 2002; 89: 729–732.Google Scholar
Asai T, Shingu K. Use of the laryngeal tube during emergence from anaesthesia in a patient with an unstable neck. Anaesthesia 2004; 59: 300–301.Google Scholar
Asai T, Moriyama S, Nishita Y, Kawachi S. Use of the laryngeal tube during cardiopulmonary resuscitation by paramedical staff. Anaesthesia 2003; 58: 393–394.Google Scholar
Wrobel M, Grundmann U, Wilhelm W, Wagner S, Larsen R. Laryngeal tube versus laryngeal mask airway in anaesthetised non-paralysed patients. A comparison of handling and postoperative morbidity. Anaesthesist 2004; 53: 702–708.Google Scholar
Gaitini LA, Vaida SJ, Somri M, Yanovski B, Ben-David B, Hagberg CA. A randomized controlled trial comparing the ProSeal laryngeal mask airway with the laryngeal tube suction in mechanically ventilated patients. Anesthesiology 2004; 101: 316–320.Google Scholar
Casati A, Fanelli G, Casaletti E, Cedrati V, Veglia F, Torri G. The target plasma concentration of propofol required to place laryngeal mask versus cuffed oropharyngeal airway. Anesth Analg 1999; 88: 917–920.Google Scholar
Muzi M, Robinson BJ, Ebert TJ, O'Brien TJ. Induction of anesthesia and tracheal intubation with sevoflurane in adults. Anesthesiology 1996; 85: 536–543.Google Scholar
Dixon WJ. Staircase bioassay: the up-and-down method. Neurosci Biobehav Rev 1991; 15: 47–50.Google Scholar
Dixon W. Quantal-response variable experimentation: the up-and-down method. In: McArthur JW, Colton T, eds. Statistics in Endocrinology. Cambridge, UK: MIT Press, 1967.
Woods AW, Grant S, Harten J, Noble JS, Davidson JA. Tracheal intubating conditions after induction with propofol, remifentanil and lignocaine. Eur J Anaesthesiol 1998; 15: 714–718.Google Scholar
Brown GW, Patel N, Ellis FR. Comparison of propofol and thiopentone for laryngeal mask insertion. Anaesthesia 1991; 46: 771–772.Google Scholar
Kodaka M, Okamoto Y, Koyama K, Miyao H. Predicted values of propofol EC50 and sevoflurane concentration for insertion of laryngeal mask Classic and ProSeal. Br J Anaesth 2004; 92: 242–245.Google Scholar
Martin G, Breslin DS, MacLeod DB et al. A study of anesthetic drug utilization in different age groups. J Clin Anaesth 2003; 15: 194–200.Google Scholar
Ouattara A, Boccara G, Lemaire S et al. Target-controlled infusion of propofol and remifentanil in cardiac anaesthesia: influence of age on predicted effect-site concentrations. Br J Anaesth 2003; 90: 617–622.Google Scholar
Kazama T, Takeuchi K, Ikeda K et al. Optimal propofol plasma concentration during upper gastrointestinal endoscopy in young, middle-aged, and elderly patients. Anesthesiology 2000; 93: 662–669.Google Scholar
Shafer A, Shafer SL, White PF. Pharmacokinetics and pharmacodynamics of propofol infusions during general anesthesia. Anesthesiology 1988; 69: 348–356.Google Scholar