A COMPARATIVE EVALUATION OF MIDAZOLAM - THIOPENTONE WITH PROPOFOL ON LARYNGEAL MASK AIRWAY INSERTION CONDITION

BACKGROUND AND AIMS: Laryngeal mask airway (LMA), an alternative airway device, provides and maintains a seal around the laryngeal inlet for spontaneous ventilation as well as modest level of positive pressure ventilation. But LMA requires a sufficient depth of anaesthesia& depression of airway reflexes to avoid adverse reactions like gagging, coughing, head & limb movements etc. We intended to test the efficacy of Thiopentone and Midazolam combination as an effective alternative to Propofol for insertion of LMA. MATERIALS AND METHODS: One hundred twenty patients (18-34 years) posted for different minor procedure (< 45 min) under general anaesthesia were divided into 2 equal groups (Group TM & P) in a randomized, double-blind fashion. In group TM (n=60) Thiopentone 5mg/kg+ Midazolam 0.05 mg/kg and group P (n=60) Propofol 2.5 mg/kg was administered prior to insertion of LMA. Then the inserting condition (jaw relaxation, gagging, coughing, hiccup, laryngospasm & head and limb movement) were evaluated into 3 point scale. The response will be graded as Mild (Transient and minimal), Moderate (Response lasted not > 20 sec) and Severe (Sustained > 20sec or needed Propofol to allow LMA insertion). RESULTS: Propofol is superior to combination of thiopentone-midazolam, in terms of achieving conditions like jaw relaxation, coughing & suppression of gagging during LMA insertion but regarding other variables like laryngospasm, hiccup & patient movement, which are equally important prerequisites for successful LMA insertion, there was not much statistically significant difference found between propofol and combination of thiopentone-midazolam. CONCLUSION: Combination of thiopentone midazolam effectively blunts airway reflexes and adequately facilitates laryngeal mask airway insertion which can be comparable to propofol.