A comparison of sevoflurane induction versus propofol induction for laryngeal mask airway insertion in elderly patients.

OBJECTIVE To compare 8% or 5% sevoflurane and propofol induction according to the ease of laryngeal mask airway (LMA) placement and hemodynamic effects in elderly patients. METHODS Ninety unpremedicated American Society of Anesthesiologists (ASA) I-III male patients >65 years, undergoing day case urological surgical intervention under general anesthesia at the Numune Education and Research Hospital, Ankara, Turkey between October 2008 to May 2009 were studied. The patients were group into 3 and were administered intravenous (intravenous) 5 ug/kg alfentanil before induction. Patients in group propofol (P) (n=29), anesthesia was induced 1.5 mg/kg propofol intravenous; in Group 8 (n=28) and Group 5 (n=28) anesthesia was induced with 8% and 5% sevoflurane in 60% nitrous oxide, and 40% oxygen with tidal-volume-breath (TVB). RESULTS Induction times were as follows: in Group P = 54.76 +/- 12.29 sec; Group 8 = 69.93 +/- 18.76 sec, and in Group 5 = 92.14 +/- 27.68 sec (p<0.01). Apnea duration was longer in Group P (6.55 +/- 4.07 min.) than in group 8 (1.73 +/- 2.49 min), and group 5 (1.12 +/- 1.12 min) (p<0.01). The decrease in mean arterial pressure (MAP) before alfentanil (control) and after induction was significantly different between the groups. CONCLUSION In elderly patients who will be administered day case anesthesia, in the placement of LMA, 5 ug/kg alfentanil followed by 5% sevoflurane induction by TVB method with minimal hemodynamic changes could be an alternative to propofol induction.