The effects of esmolol, fentanyl and lidocaine on quality of Proseallarengeal mask insertion.

Purpose: Many studies have been made to find out the anesthetic management providing adequate conditions for proseallaryngeal mask airway (PLMA) insertion. In this study, we aimed to compare the effects of esmolol, fentanyl and lidocaine, co-administered with thiopental, for PLMA insertionMethods: After obtaining University Ethical Committee approval, 75 patients aged 18 ? 60 years, American Society of Anesthesiologists (ASA) physical status I-II were included to the study. Midazolam 0.04 mg/kg IV was given approximately 5 min before induction. Following 3 minutes of preoxygenation, group 1 received 2 mg/kg esmolol, group 2 received 1.5 µg/kg fentanyl and group 3 received 1 mg/kg lidocaine in 2 minutes. 30 seconds later, thiopental 5 mg/kg was administered for induction. For the maintenance of anesthesia, we used 50% air and 2 % sevoflurane in oxygen. 90 seconds after thiopental injection, first attempt for PLMA insertion was made. Six variables were noted on a 3-point scale: jaw relaxation (nil/slight/gross), easy of insertion (easy/difficult/impossible), swallowing (nil/slight/gross), coughing/gagging (nil/slight/gross), limb/ head movement (nil/slight/gross) and laryngospasm (nil/slight/gross). Systolic blood pressure (SBP), diastolic blood pressures (DBP), mean blood presure (MBP), and heart rates (HR) were recorded pre-induction, immediately after PLMA insertion, three, five, seven and ten minutes after PLMA insertion. All side effects were noted during anesthesiaResults: The 3 groups were demographically similar. Incident of full jaw relaxation and conditions for Proseallaryngeal mask airway insertion were better in esmolol group (p<0.05). There were no significant differences in haemodynamic response between the threegroups. As a result, 2 mg/kg esmolol when used 30 sec. before thiopental induction provides successful PLMA insertion compare with 1.5 µg/kg fentanyl and 1 mg/kg lidocaine.Keywords: Proseallaryngeal mask airway, thiopentone, esmolol, fentanyl, lidocaine