A Comparison of Dexmedetomidine and Fentanyl as Co-induction Agents to Propofol for Insertion of Proseal Laryngeal Mask Airway: A Randomised Clinical Study

Introduction: The Supraglottic Airway Devices (SAD) are bridges between a face mask and Endotracheal Tubes (ETT). Various induction agents like sevoflurane and propofol were used till date for smooth insertion. Propofol causes dose-dependent cardio-respiratory depression while opioids may increase the haemodynamic instability. Aim: To investigate the role of dexmedetomidine and fentanyl as co-induction agents to propofol for Proseal Laryngeal Mask Airway (PLMA) insertion conditions. Materials and Methods: The present study was a randomised clinical study in which 60 patients of American Society of Anaesthesiologists (ASA) grade I-II, 20-60 years of age were divided into two groups. Group P+D received 2.5 mg/kg propofol + 1 mu g/kg dexmedetomidine while Group P+F received 2.5 mg/kg propofol + 1 mu g/kg fentanyl. A Bispectral Index (BIS) value of 50-45 was taken as desired end point for insertion of PLMA. Induction time, insertion time, ease of insertion, number of attempts, total propofol requirement and various hemodynamic changes were taken into consideration. Results: Mean induction time with dexmedetomidine (8.28 +/- 0.81min) was lower as compared to that with fentanyl (9.28 +/- 0.83 min) (p<0.0001). Total propofol requirement was also less with dexmedetomidine (93.66 +/- 15.64 mg) as compared to that with fentanyl (135.8 +/- 10.95 mg). Dexmedetomidine also provided better insertion score for PLMA (p=0.044) with less number of attempts (p=0.044), when compared with fentanyl. Conclusion: Dexmedetomidine, as an adjuvant to propofol can be considered as an attractive choice for insertion of PLMA.