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Comparison of the anaesthetic requirement with target-controlled infusion of propofol to insert the laryngeal tube vs. the laryngeal mask

  • P. Richebé (a1), B. Rivalan (a1), L. Baudouin (a1), M. Sesay (a1), F. Sztark (a2), A.-M. Cros (a3) and P. Maurette (a1)...

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Summary

Background and objective: The target effect-site concentration of propofol to insert a laryngeal mask airway was recently reported as almost 5 μg mL−1. The present study aimed to determine the target effect-site concentration with target-controlled infusion of propofol to place classical larnygeal mask airway or current laryngeal tube in adult patients. Methods: We included 40 patients scheduled for short gynaecological and radiological procedures under general anaesthesia in a randomized, double-blind manner using the Dixon's up-and-down statistical method. Monitoring included standard cardiorespiratory monitors, and bispectral index monitoring was used for all patients. Anaesthesia was conducted with a target-controlled infusion system: Diprifusor. The initial target plasma concentration of propofol was 5 μg mL−1, and was changed stepwise by 0.5 μg mL−1 increments according to Dixon's up-and-down method. Criteria for acceptable insertion were: Muzi's score ≤2, and mean arterial blood pressure, heart rate or bispectral index variation <20% the baseline values.Results: Target effect-site concentration of propofol required to insert laryngeal tube was 6.3 ± 0.3 μg mL−1 with Dixon method and ED50 was 6.1 μg mL−1 (5.9–6.4) with logistic regression method. In the case of larnygeal mask airway they were 7.3 ± 0.2 μg mL−1 (Dixon method) and 7.3 μg mL−1 (7.1–7.5; with logistic regression) respectively (P < 0.05). ED95 (logistic regression) was 6.8 μg mL−1 (5.9–7.6) for laryngeal tube and 7.7 μg mL−1 (7.3–8.0) for larnygeal mask airway (P < 0.05). Haemodynamic incidents were 55% in the larnygeal mask airway group vs. 30% in the laryngeal tube group (P < 0.05). Conclusions: The target effect-site concentration of propofol for insertion of laryngeal tube was lower than for larnygeal mask airway (P < 0.05), with a consequent reduction of the propofol induced haemodynamic side-effects.

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Corresponding author

Correspondence to: Philippe Richebé, Service du Pr Pierre Maurette, Département d'Anesthésie et Réanimation III, Hôpital Pellegrin, Place Amélie Raba Léon, CHU de Bordeaux, 33076 Bordeaux Cedex, France. E-mail: philippe.richebe@u-bordeaux2.fr; Tel:+33 5 56 79 55 15; Fax:+33 5 57 57 14 12

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Keywords

Comparison of the anaesthetic requirement with target-controlled infusion of propofol to insert the laryngeal tube vs. the laryngeal mask

  • P. Richebé (a1), B. Rivalan (a1), L. Baudouin (a1), M. Sesay (a1), F. Sztark (a2), A.-M. Cros (a3) and P. Maurette (a1)...

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