Midazolam or mini-dose succinylcholine as a co-induction

BACKGROUND: Laryngeal Mask Airway (LMA) fills a niche between the facemask and endotracheal tube. For LMA insertion, use of only propofol as sole induction agent has less success rate. So many co-induction agents had been tried to get better success rate. Aim: To evaluate whether midazolam or mini-dose succinylcholine eases LMA insertion during propofol anaesthesia. MATERIALS AND METHOD: 75 adult patients of ASA grade I & II were divided in three groups (n=25) for surgery of up to one hour duration. Group-P was Propofol group (2.5mg/kg), Group-PM was propofol (2.5mg/kg) & midazolam (.04mg/kg) & Group-PS was Propofol (2.5mg/kg) & succinylcholine (0.25mg/kg). RESULTS: Parameters observed were jaw relaxation, airway reflexes & successful insertion at first attempt, overall insertion conditions & any other side effects. Hemodynamic changes during LMA insertion were found to be stable in groups PM& PS than group P. Dose of propofol required for LMA insertion was less in PM (2.52mg/kg) & PS (2.66mg/kg) groups than group P (3.1mg). Success rate at first attempt was significantly high in PM (88%) & PS (84%) groups compared to group P (56%). Overall exellent to acceptable conditions for LMA insertion were observed in PM (92%) & PS groups (88%) than group P(52%). CONCLUSION: propofol as a sole agent did not produce satisfactory conditions for LMA insertion with normal dose. This can be improved by addition of midazolam or low dose succinylcholine providing haemodynamic stability and minimum side effects.