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Journal of Obstrectic Anaesthesia and Critical Care
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ORIGINAL ARTICLE
Year : 2019  |  Volume : 9  |  Issue : 1  |  Page : 18-23

I-gel for day care diagnostic laparoscopic gynecological surgery: A comparison of two regimes of IV propofol with dexmedetomidine or butorphanol


Department of Anaesthesiology and Critical Care, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India

Correspondence Address:
Dr. Apoorva Gupta
26, Navratna Complex, Bedla Road, Udaipur - 313 001, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joacc.JOACC_65_18

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Background: Insertion of I-gel requires adequate depth of anesthesia and jaw relaxation in an unparalyzed patient. Propofol with adjuvants is commonly used to facilitate I-gel insertion. This study was conducted to compare ease of insertion by addition of either dexmedetomidine or butorphanol added to propofol for insertion of I-gel in gynecological laparoscopic surgeries. Materials and Methods: About 120 female patients, the American Society of Anesthesiologists (ASA) Grade I–II, 18–40 years, and body mass index (BMI) <30 kg/m2 were allocated randomly either to receive dexmedetomidine 0.5 mcg/kg IV (Group I) or butorphanol 0.02 mg/kg IV (Group II). Ease of insertion score was determined by jaw mobility grading, number of attempts, need of manipulation, limb movement and bucking, use of laryngoscope and muscle relaxant, and time taken for insertion. Adverse events like expiratory stridor, lacrimation, breath holding, and audible air leak after insertion were also noted. Intraoperative monitoring included heart rate (HR), mean arterial pressure (MAP), and oxygen saturation at 0–15 min of I-gel insertion. Post-operative side effects like coughing, laryngospasm, hiccups, and sedation were also noted. Results: The efficacy of successful insertion of I-gel was significantly higher in propofol-dexmedetomidine (Group I) as compared to propofol–butorphanol (Group II) (P < 0.001). Significant fall in HR from baseline to 15 min after I-gel insertion (88.65 ± 14.84 to 71.90 ± 12.15 bpm) was found in Group I as compared to Group II (87.60 ± 12.71 to 83.52 ± 10.91 bpm, P < 0.001). There was a fall in MAP from baseline values after induction upto 15 min following insertion in Group I (96.72 ± 13.54 to 86.96 ± 11.03), while in Group II fall in MAP from baseline was observed only upto 1 and 2 min of I-gel insertion (96.27 ± 9.53 to 89.42 ± 9.03) (P < 0.001). Conclusion: Addition of dexmedetomidine to propofol provided significantly better insertion characteristics for I-gel and adequate hemodynamic stability with minimal complications compared to butorphanol.


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