A prospective, randomized, double-blind entropy-guided approach to evaluate the efficacy of different doses of dexmedetomidine with propofol versus fentanyl with propofol for ProSeal laryngeal mask airway insertion

Background: Airway management with Proseal Laryngeal Mask Airway (PLMA) is increasingly being used. PLMA insertion requires adequate jaw relaxation and depth of anesthesia while maintaining hemodynamic stability. Opioids including fentanyl and alpha-2 agonists like dexmedetomidine are increasingly b...

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Main Authors: Mahantesh Mudakanagoudar, Bhavana Koppad, Manjunath Shivapujimath, Meghana Hanagandi
Format: Article
Language:English
Published: Krishna Vishwa Vidyapeeth (Deemed to be University), Karad 2025-01-01
Series:Journal of Krishna Institute of Medical Sciences University
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Online Access:https://www.jkimsu.com/jkimsu-vol14no1/JKIMSU,%20Vol.%2014,%20No.%201,%20January-March%202025%20Page%20116-127.pdf
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author Mahantesh Mudakanagoudar
Bhavana Koppad
Manjunath Shivapujimath
Meghana Hanagandi
author_facet Mahantesh Mudakanagoudar
Bhavana Koppad
Manjunath Shivapujimath
Meghana Hanagandi
author_sort Mahantesh Mudakanagoudar
collection DOAJ
description Background: Airway management with Proseal Laryngeal Mask Airway (PLMA) is increasingly being used. PLMA insertion requires adequate jaw relaxation and depth of anesthesia while maintaining hemodynamic stability. Opioids including fentanyl and alpha-2 agonists like dexmedetomidine are increasingly being used with propofol for the same. Aims and Objectives: To assess efficacy of different dexmedetomidine doses in providing optimal conditions for insertion of PLMA, compare with that of fentanyl, and correlate with Entropy. Material and Methods: Prospective double-blind, randomized study was conducted on 120 individuals between 18 - 65 years of ASA I /II and had been randomized into 4 groups: Group 1 - Dexmedetomidine 0.5 μg/kg, Group 2 - Dexmedetomidine 0.75 μg/kg, Group 3 - Dexmedetomidine 1μg/kg and Group 4 - Fentanyl 2μg/kg. Standard anesthesia monitors with entropy sensors were attached. Study drug was administered over 10 minutes, followed by a propofol bolus; once the State Entropy was less than 50, PLMA was inserted after assessing jaw relaxation. Results: Both groups were similar in demographic data and insertion conditions. Systolic blood pressure, mean arterial pressure, and diastolic blood pressure reductions were larger in group fentanyl. Apnea time was more infentanyl group than the dexmedetomidine group but was not statistically significant. Conclusion: Different doses of dexmedetomidine in conjunction with propofol provide identical PLMA insertion settings as fentanyl propofol combination, better maintenance advantage of hemodynamics, and less apnea incidence with adequate depth of anesthesia.
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spelling doaj-art-649d41c2d6cf4fc9ad81a8950f795d8b2025-08-25T11:13:51ZengKrishna Vishwa Vidyapeeth (Deemed to be University), KaradJournal of Krishna Institute of Medical Sciences University2231-42612025-01-01141116127A prospective, randomized, double-blind entropy-guided approach to evaluate the efficacy of different doses of dexmedetomidine with propofol versus fentanyl with propofol for ProSeal laryngeal mask airway insertionMahantesh Mudakanagoudar0Bhavana Koppad1Manjunath Shivapujimath2Meghana Hanagandi3Department of Anaesthesiology, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (KAHER) Belagavi-590010 (Karnataka) IndiaDepartment of Paediatrics, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (KAHER) Belagavi-590010 (Karnataka) IndiaDepartment of Anaesthesiology, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (KAHER) Belagavi-590010 (Karnataka) IndiaDepartment of Anaesthesiology, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (KAHER) Belagavi-590010 (Karnataka) IndiaBackground: Airway management with Proseal Laryngeal Mask Airway (PLMA) is increasingly being used. PLMA insertion requires adequate jaw relaxation and depth of anesthesia while maintaining hemodynamic stability. Opioids including fentanyl and alpha-2 agonists like dexmedetomidine are increasingly being used with propofol for the same. Aims and Objectives: To assess efficacy of different dexmedetomidine doses in providing optimal conditions for insertion of PLMA, compare with that of fentanyl, and correlate with Entropy. Material and Methods: Prospective double-blind, randomized study was conducted on 120 individuals between 18 - 65 years of ASA I /II and had been randomized into 4 groups: Group 1 - Dexmedetomidine 0.5 μg/kg, Group 2 - Dexmedetomidine 0.75 μg/kg, Group 3 - Dexmedetomidine 1μg/kg and Group 4 - Fentanyl 2μg/kg. Standard anesthesia monitors with entropy sensors were attached. Study drug was administered over 10 minutes, followed by a propofol bolus; once the State Entropy was less than 50, PLMA was inserted after assessing jaw relaxation. Results: Both groups were similar in demographic data and insertion conditions. Systolic blood pressure, mean arterial pressure, and diastolic blood pressure reductions were larger in group fentanyl. Apnea time was more infentanyl group than the dexmedetomidine group but was not statistically significant. Conclusion: Different doses of dexmedetomidine in conjunction with propofol provide identical PLMA insertion settings as fentanyl propofol combination, better maintenance advantage of hemodynamics, and less apnea incidence with adequate depth of anesthesia.https://www.jkimsu.com/jkimsu-vol14no1/JKIMSU,%20Vol.%2014,%20No.%201,%20January-March%202025%20Page%20116-127.pdfproseal laryngeal mask airwaydexmedetomidinefentanylentropy
spellingShingle Mahantesh Mudakanagoudar
Bhavana Koppad
Manjunath Shivapujimath
Meghana Hanagandi
A prospective, randomized, double-blind entropy-guided approach to evaluate the efficacy of different doses of dexmedetomidine with propofol versus fentanyl with propofol for ProSeal laryngeal mask airway insertion
Journal of Krishna Institute of Medical Sciences University
proseal laryngeal mask airway
dexmedetomidine
fentanyl
entropy
title A prospective, randomized, double-blind entropy-guided approach to evaluate the efficacy of different doses of dexmedetomidine with propofol versus fentanyl with propofol for ProSeal laryngeal mask airway insertion
title_full A prospective, randomized, double-blind entropy-guided approach to evaluate the efficacy of different doses of dexmedetomidine with propofol versus fentanyl with propofol for ProSeal laryngeal mask airway insertion
title_fullStr A prospective, randomized, double-blind entropy-guided approach to evaluate the efficacy of different doses of dexmedetomidine with propofol versus fentanyl with propofol for ProSeal laryngeal mask airway insertion
title_full_unstemmed A prospective, randomized, double-blind entropy-guided approach to evaluate the efficacy of different doses of dexmedetomidine with propofol versus fentanyl with propofol for ProSeal laryngeal mask airway insertion
title_short A prospective, randomized, double-blind entropy-guided approach to evaluate the efficacy of different doses of dexmedetomidine with propofol versus fentanyl with propofol for ProSeal laryngeal mask airway insertion
title_sort prospective randomized double blind entropy guided approach to evaluate the efficacy of different doses of dexmedetomidine with propofol versus fentanyl with propofol for proseal laryngeal mask airway insertion
topic proseal laryngeal mask airway
dexmedetomidine
fentanyl
entropy
url https://www.jkimsu.com/jkimsu-vol14no1/JKIMSU,%20Vol.%2014,%20No.%201,%20January-March%202025%20Page%20116-127.pdf
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