A comparison of midazolam and mini-dose succinylcholine to aid laryngeal mask airway insertion during propofol anaesthesia

Abstract EN

The laryngeal mask airway (LMA) insertion with the use of protocol as a single agent for induction of an aesthesia was not associated with high incidence of success.

Many co-induction drugs had been used to improve the insertion condition.

This study investigated the use of mid-asylum (M) or the use of mini-dose succinylcholine (S) as a co-induction agent with protocol to facilitate LMA insertion in 60 patients ASA I-II subjected to out-patient surgery.

The patients were divided into three groups : pro-pool group (P) received intravenous protocol 2.5 mg / kg for induction of an aesthesia, group PM received intravenous midazolam 0.04 mg / kg 3 min before protocol and group PS received intravenous succinylcholine 0.1 mg / kg 30s after protocol.

The number of (LMA) insertion attempts and the total protocol dose were recorded.

Patients were assessed for jaw relaxation, gagging, coughing, patient movement, laryngospasm and the overall insertion condition.

Also, the hemodynamic changes and apneal were recorded.

Fasciculation and myalgia were assessed in group PS.

Significant reduction in the induction dose of protocol was observed in PM group (40 %).

The success rate at first attempt was 60 %, 95 % and 90 % in the three groups, respectively (P, PM, PS).

The overall insertion condition was excellent in 20 %, 75 %, 50 % in group P, PM, PS, respectively.

The number of patients with no gagging, coughing, patient movement or laryngospasm was significantly higher in group PM and PS compared to group P.

Group PM showed less hemodynamic change and a shorter duration of apnea after LMA insertion.

The incidence of fasciculation and myalgia was 20 % in group PS.

The study showed that protocol, as a single agent, did not produce a satisfactory condition for LMA insertion.

This can be improved by the use of midazolam or mini-dose succinylcholine.

Midazolam had the advantage of reducing the dose of propanol and providing hemodynamic stability.

Mini-dose of succinylcholine had the disadvantage that it cannot be used in patients with plasma cholinesterase deficiency and should be avoided in patients prone to myalgia.