Comparison of hemodynamic and respiratory effects of clonidine combined withpropofol versus fentanyl propofolfor insertion of AMBU LMA

Abstract

Background: AMBU LMA is an airway device that requires adequate depth of anaesthesia and
suppression of upper airway reflexes thereby providing optimal insertion conditions.
Aim: To compare clonidine and fentanyl for coinduction with propofol with respect to AMBU
LMA insertion conditions, haemodynamicvariation,respiratory effect and the total dose
requirement of propofol.
Materials and methods: This was a prospective randomized study, a total of 90 patients
belonging to the American Society of Anesthesiologists (ASA 1 and 2) Patients were
randomized into three groups to receive either propofol with clonidine or propofol with fentanyl
and propofol only during insertion of AMBU LMA, Ninety seconds after propofol injection,
AMBU LMA of appropriate size was inserted. Proper placement was confirmed by capnography.
Conditions of AMBU LMA insertion were recorded and assessed, haemodynamic parameters,
namely Heart rate(HR), mean blood pressure (MAP) ,spontaneous respiratoy rate were recorded
and assessed before and after the insertion of AMBU LMA, at the end of 1st, 2nd, 3rd, 5th and
10th minute after the insertion. Informed consent and IEC clearance obtained. Statistical
Analysis was done using SPSS 19.0.
Result: The mean Heart rate in patients who received combination of Clonidine with Propofol
drugs has better hemodynamically stable over in patients who received antanyl-Propofol and
patients who received only Propofol and this difference observed statistically significant at the
3min, 5min and 10min. The Mean Arterial pressure is initially increased, who received
combination of Clonidine and Propofol drugs at pre operatively. During AMBU LMA insertion
and later from 1min, 3min, 5min and 10min, Clonidine-propofol group has lesser Mean Arterial
pressure compared to those who received Fentanyl Propofol and Propofol only, this difference is
statistically significant at all-time intervals. The mean basal RR were comparable (p>0.05) in
three groups. There was statistically significant (p<0.001) increase in the RR in Group D from 5
min onwards after insertion of AMBU LMA which got stabilized at 10 min.