Effect of Propofol Alone and Propofol+Muscle Relaxant Combination on Laryngeal Mask Airway Insertion and Hemodynamic Parameters During Anesthesia Induction: A Randomized Clinical Trial

Background: Successful insertion of a laryngeal mask airway (LMA) requires deep anesthesia, the proper opening of the mouth, and adequate suppression of upper airway reflexes. Propofol injection can effectively reduce laryngeal reflexes. This study aimed to compare the effectiveness of propofol alone versus propofol plus a muscle relaxant on LMA insertion and hemodynamic parameters during the induction of anesthesia. Methods: This randomized, double-blind clinical study was performed on 70 patients in the age range of 18-65 years who were candidates for surgery in the operating room of Shahid Mohammadi Hospital in Bandar Abbas, Iran in 2020. The patients were randomly divided into two groups of 35. The first group received propofol and normal saline, and the second group received propofol plus cisatracurium. The parameters of ease of LMA insertion, jaw opening, cough and gag reflexes, head and limb movement, laryngospasm, and hemodynamic changes were recorded for investigation. Results: The patients were almost matched in terms of demographic variables. No significant difference was found regarding the ease of LMA insertion and hemodynamic parameters. However, the overall score of ease of LMA insertion was considerably higher in the propofol plus muscle relaxant group (P=0.029). The extubation time was significantly shorter (P<0.001) and the surgery duration was considerably longer (P=0.019) in the propofol plus muscle relaxant group. Conclusion: The findings demonstrated that both techniques were suitable for LMA insertion, and no significant hemodynamic changes were found between the two groups. However, the administration of propofol plus a muscle relaxant was more suitable due to ease of LMA insertion and shorter extubation time.