Key result
Sevoflurane plus alfentanil provided excellent or satisfactory conditions for laryngeal mask insertion in 100% of patients, compared to 88% for propofol-alfentanil and 64% for either alone.
Why the study?
Does the combination of sevoflurane or propofol with alfentanil improve conditions for laryngeal mask insertion compared to either agent alone in patients undergoing elective surgery?
RCT (n=100)
Randomised parallel groups
Does the combination of sevoflurane or propofol with alfentanil improve conditions for laryngeal mask insertion compared to either agent alone in patients undergoing elective surgery?
A sevoflurane-alfentanil combination provides superior conditions for laryngeal mask insertion compared to sevoflurane alone or a propofol-alfentanil combination.
Answers are grounded in this paper and cite their sources.
Favors sevoflurane-alfentanil for laryngeal mask insertion in elective surgery; RCT confirms combination superiority over either agent alone.
One hundred unpremedicated ASA 1 or 2 patients scheduled for elective surgery were divided equally into four groups and recruited into this prospective, randomised parallel groups study. Induction was with propofol 2.5 mg.kg-1 or vital-capacity breath induction with sevoflurane (> 7% in the inspiratory gas) in 65% nitrous oxide and oxygen, or gaseous induction with sevoflurane plus alfentanil 5 micrograms.kg-1 or propofol 2.5 mg.kg-1 and alfentanil 5 micrograms.kg-1. The conditions for laryngeal mask insertion were assessed and graded on a three-point scale using six variables. The overall condition for laryngeal mask insertion was assessed as excellent, satisfactory or poor on the basis of total score in each group. Excellent or satisfactory conditions were observed in 25 (100%) patients in the sevoflurane-alfentanil group, 22 (88%) in the propofol-alfentanil group and 16 (64%) patients each in the propofol and sevoflurane groups (p < 0.001). A sevoflurane-alfentanil combination provides better conditions for laryngeal mask insertion when compared with sevoflurane alone, or a propofol-alfentanil combination.
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Sivalingam et al. (1999) conducted an RCT in Elective surgery (n=100). Sevoflurane plus alfentanil vs. Sevoflurane alone, propofol alone, and propofol plus alfentanil was evaluated on Excellent or satisfactory conditions for laryngeal mask insertion (p=< 0.001). Sevoflurane plus alfentanil provided excellent or satisfactory conditions for laryngeal mask insertion in 100% of patients, compared to 88% for propofol-alfentanil and 64% for either alone.
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