Topical lignocaine and thiopentone for the insertion of a laryngeal mask airway - A comparison with propofol

We assessed conditions for insertion of a laryngeal mask airway in 90 unpremedicated adult patients who received either, thiopentone 5 mg.kg(-1) preceded by 40 mg of topical lignocaine spray to the posterior pharyngeal wall or propofol 2.5 mg.kg(-1) alone in a randomised, single-blinded trial. All patients received fentanyl 1 mu g.kg(-1). Gagging, coughing and laryngospasm following laryngeal mask insertion were graded and haemodynamic data and apnoea times were recorded. There were no significant differences between the two groups with regard to the incidence of gagging, coughing and laryngospasm, but the apnoea time was significantly less in the thiopentone group (p < 0.005). The decrease in systolic and diastolic blood pressure, following induction and the insertion of a laryngeal mask with propofol was significantly greater than following thiopentone (p < 0.05-systolic, p < 0.01-diastolic). We conclude that thiopentone preceded by topical lignocaine spray provides conditions for insertion of a laryngeal mask equal to those of propofol, with more haemodynamic stability and a shorter period of apnoea.