The ideal combination that provides smooth insertion conditions with minimal
side effects has not been identified, particularly in children. In this study, 70 children of
age 3-12 years are divided randomly into 2 groups: Group 1-Group-F-Fentanyl (n=35)
received Fentanyl 2μg/kg and Group 2-Group –K- Ketamine (n=35) received Ketamine
0.5mg/kg before induction of anaesthesia..Baseline heart rate and arterial blood pressure
were measured. Vital parameters (Heart rate and Arterial Blood Pressure) were measured
before induction, before LMA insertion and thereafter at 1, 3 and 5 minutes after LMA
insertion. Ideal LMA insertion conditions were evaluated with six variables by blinded
observer: mouth opening, gagging, .head and limb movements, laryngospasm and
resistance to insertion. Also the apnoea time was noted.
RESULTS:
The incidence of head/limb movements was statistically significant and Group
Propofol – Ketamine showed 22% compared to Fentanyl-Propofol group (2.8%)
Coughing/gagging was seen in 2.86% of both the groups. Resistance to insertion was
statistically significant with p value of 0.0268 showing more in Propofol + Ketamine.
There was no statistical significance in the occurrence of restricted mouth opening,
restriction to LMA insertion and occurrence of swallowing between the two groups.
Laryngospasm was absent in either groups. Fentanyl group showed the incidence of more
apnoea (34.28) compared to Ketamine group (14.2).The heart rate (HR ),systolic blood
pressure(SBP), diastolic blood pressure(DBP) and mean arterial pressure(MAP) were
statistically more with Ketamine group than Fentanyl group.
CONCLUSION:
Co-induction with Fentanyl (2μ/kg) prior to Propofol (2.5mg/kg) induction for
insertion of Laryngeal Mask Airway in children provided better insertion condition with
minimal increase in heart rate, systolic blood pressure, diastolic blood pressure and mean
arterial pressure than admixture of Ketamine (0.5mg/kg) with Propofol
