Comparing the use of sevoflurane versus propofol for anesthesia induction during laryngeal mask airway insertion in outpatient urological surgeries.

Abstract

Objective: To compare the effectiveness of sevoflurane and propofol for anesthesia induction during laryngeal mask airway insertion in outpatient urological surgeries. Study Design: Randomized Controlled Trial. Setting: Department of Anesthesia, Fauji Foundation Hospital, Rawalpindi. Period: January 2022 to June 2022. Methods: A total of 60 patients aging ≥ 18 years, undergoing planned urological procedures were enrolled and randomized into two equal groups of 30 patients each. In Group P, induction was done using intravenous Propofol 2 mg/kg administered over 30 seconds. In Group S induction was done using Sevoflurane (8%) in 100% oxygen via a facemask. After achieving adequate conditions, LMA Classic^TM was inserted as per recommended technique. Primary outcomes included, the time for successful insertion of laryngeal mask airway, frequency of apnea and complications related to insertion and the post-induction mean arterial pressure. The outcomes of the two groups were compared by applying Chi-squared test and Independent t-test, taking p≤0.05 as significant. Results: The study participants had a mean age of 41.43±8.24 years, with males comprising 56.66% and females comprising 43.33% of total population. The results of study outcomes show that laryngeal mask airway insertion time was significantly higher in Group S compared to the Group P (p ˂0.0001). On the other hand, the incidence of apnea and complications related to insertion were significantly higher in Group P compared to Group S (p=0.03 & p=0.02 respectively). Regarding the hemodynamic findings, a significantly lower mean arterial pressure was observed at 6 minutes after induction in Group P compared to Group S (p=0.01). Conclusion: Sevoflurane offers fewer complications along with better hemodynamic stability despite longer laryngeal mask airway insertion time compared to propofol for outpatient urological procedures.