Comparison Of The Effects Of Propofol-Dexmedetomidine And Thiopental-Dexmedetomidine Combinations On The Success Of Classical Laryngeal Mask Airway Insertion

A total of 80 patients aged 18–65 years with ASA I-II physical status undergoing elective surgery with LMA insertion were included. Muscle relaxants were not used, and surgeries were limited to less than 2 hours. Patients with neck or upper respiratory pathologies, difficult airway history, morbid obesity, lung disease, or chronic sedative/opioid use were excluded. All patients underwent standard monitoring (HR, SAP, DAP, MAP, ECG, and SpO2) prior to anesthesia induction. Anesthesia depth was measured using bispectral index (BIS) monitoring. A 20G IV cannula was inserted, and 7 mL·kg saline infusion was administered. Group P (Control Group): 2 µg/kg remifentanil followed by 2.5 mg/kg propofol. Group T (Intervention Group): 2 µg/kg remifentanil followed by 5 mg/kg thiopental. After induction, the LMA was inserted 90 seconds later when BIS was <40 and jaw relaxation was sufficient. Placement was performed by a single, experienced researcher using the standard technique, and cuff pressure was maintained at 60 cmH2O. Assessment of LMA Insertion: Conditions for LMA insertion were evaluated during the first attempt only using a 6-variable scale (jaw opening, ease of insertion, swallowing, coughing, laryngospasm, and movement). Insertion conditions were rated as: Optimal: All criteria were excellent. Acceptable: A mix of excellent and good criteria. Poor: At least one poor criterion. Monitoring Adherence to the Intervention: Drug preparation and administration were conducted using blinded syringes. A researcher independent of the anesthesia process monitored LMA placement conditions and patient responses. Adherence was ensured through detailed documentation of drug dosages, LMA attempts, and peroperative parameters. Perioperative and Postoperative Outcomes: SAP, DAP, MAP, HR, BIS, and SpO2 were recorded 1 minute before and at 1, 2, 3, 4, and 5 minutes after LMA insertion. Apnea duration, defined as the time from the last spontaneous breath after induction to the first spontaneous breath, was recorded. Postoperatively, patients were evaluated for: Sore Throat: Rated on a 0–3 scale (none, mild, moderate, severe). Dysphagia: Presence or absence determined by difficulty swallowing water. Blood Presence on LMA: Graded as none, trace, or significant. Hypotension (MAP <30% below baseline) was treated with 6 mg of ephedrine, and bradycardia (HR <50 bpm) was treated with 0.5 mg IV atropine.