Comparison of the Effects of Lidocaine and Dexmedetomidine Before Propofol Induction During Laryngeal Mask Airway Insertion
1University of Health Sciences, Antalya Training and Research Hospital, Clinic of Anaesthesiology and Reanimation, Antalya, Turkey
2Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, Department of Medical Education, İstanbul, Turkey
Eur Arch Med Res 2019; 35(4): 205-210 DOI: 10.4274/eamr.galenos.2018.48344
Full Text PDF

Abstract

Objective: Laryngeal mask (LMA) is an airway device that can be used as an alternative to face mask and tracheal intubation. Different drug combinations can be used to ensure suitable conditions during LMA insertion. Lidocaine and dexmedetomidine are drugs that can be used to reduce hemodynamic response and suppress oropharyngeal reflexes during both intubation and LMA insertion. The aim of this study was to investigate the effects of lidocaine and dexmedetomidine on LMA insertion.

Methods: Sixty patients who were scheduled to undergo cystoscopy under general anesthesia with LMA were included in the study. Patients were randomly divided into two groups: Group L (those who received 1.5 mg/kg lidocaine) and Group D (those who received 1 μg/kg dexmedetomidine). Number of attempts of LMA insertion, ease of LMA insertion, mouth opening, laryngospasm, gumming, stomach distention, limb movements and spontaneous breathing and hemodynamic parameters were recorded.

Results: There was no statistically significant difference between the two groups in terms of the number of attempts of LMA insertion. In the first attempt, the LMA insertion success rate was 70% for Group L and 73.3% for Group D. There was no statistically significant difference between the two groups in terms of mouth opening, laryngospasm, ease of LMA insertion, gumming, stomach distension, limb movement and spontaneous breathing. Systolic blood pressure, diastolic blood pressure, mean blood pressure and heart rate were statistically lower in Group D after drug administration. It was determined that the decreases in the other times were statistically significant compared to the baseline values after drug administration in both groups.

Conclusion: Based on the results of the present study, 1 μg/kg dexmedetomidine and 1.5 mg/kg lidocaine used before propofol induction provided similar conditions for LMA insertion. Dexmedetomidine has a more hypotensive effect and provides a greater reduction in heart rate than lidocaine. Furthermore, the use of lidocaine before propofol induction provides better hemodynamic control than dexmedetomidine.