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The Effect of Adding Remifentanil to Thiopental for Anaesthesia Induction on the Success of Classic Laryngeal Mask Airway Insertion: A Randomised Double-Blind Clinical Trial
 
 
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Article

Thiopental Versus Propofol in Combination with Remifentanil for Successful Classic Laryngeal Mask Airway Insertion: A Prospective, Randomised, Double-Blind Trial †

1
Intensive Care Unit, Department of Anesthesiology and Reanimation, Izmir Acibadem Kent Hospital, 35580 Izmir, Turkey
2
Intensive Care Unit, Department of Anesthesiology and Reanimation, Izmir City Hospital, University of Health Sciences, 35120 Izmir, Turkey
3
Intensive Care Unit, Department of Anesthesiology and Reanimation, Firat University School of Medicine Hospital, 23119 Elazig, Turkey
4
Intensive Care Unit, Department of Anesthesiology and Reanimation, Izmir Tepecik Training and Research Hospital, University of Health Sciences, 35180 Izmir, Turkey
5
Department of Anesthesiology and Reanimation, Ankara University Ibni Sina Hospital, 06230 Ankara, Turkey
6
Department of Anesthesiology and Reanimation, Istanbul Training and Research Hospital, 34098 Istanbul, Turkey
*
Author to whom correspondence should be addressed.
The abstract of this manuscript was published as Oral Presentation (Presentation ID: 780) At The 11th International Medicine And Health Sciences Researches Congress (UTSAK, online, 24–25 December 2022).
These authors contributed equally to this work.
Pharmaceuticals 2025, 18(8), 1173; https://doi.org/10.3390/ph18081173
Submission received: 25 June 2025 / Revised: 27 July 2025 / Accepted: 4 August 2025 / Published: 8 August 2025
(This article belongs to the Special Issue Use of Anesthetic Agents: Management and New Strategy)

Abstract

Background: Remifentanil, an ultra-short-acting μ-receptor agonist, is used with propofol or thiopental for tracheal intubation without muscle relaxants. While effective with both, its combination with thiopental provides better hemodynamic stability. Thiopental has long been a standard intravenous agent for anaesthesia induction and remains a cost-effective alternative to propofol in resource-limited settings. To date, no study has directly compared the effects of thiopental–remifentanil and propofol–remifentanil combinations on LMA insertion conditions. This study aims to compare the effects of thiopental or propofol with 2 µg·kg−1 remifentanil on laryngeal mask airway (LMA) insertion conditions and success in a prospective, randomised double-blind study. Method: The study included 80 premedicated ASA I-II patients, aged 18–65, randomised into Group P (propofol) and Group T (thiopental). Anaesthesia induction was with 2 μg·kg−1 remifentanil, followed by 5 mg·kg−1 thiopental or 2.5 mg·kg−1 propofol. LMA insertion occurred 90 s post-induction. LMA insertion conditions were evaluated using a six-variable scale. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR), and bispectral index monitor (BIS) values were recorded at baseline, 1 min pre-insertion, and at 1, 2, 3, 4, and 5 min after insertion. Apnoea duration, loss of eyelash reflex duration, insertion duration, number of attempts, and perioperative complications were also documented. Results: Demographic data were similar. Group P showed significantly shorter eyelash reflex loss and LMA insertion durations, longer apnoea duration, and higher rates of full mouth opening, excellent LMA insertion condition, and hypotension or bradycardia compared to Group T (p < 0.05). Group P had significantly lower HR, SAP, DAP, and MAP at various time points (p < 0.05). There were no significant differences in blood presence on LMA, sore throat, or dysphagia (p > 0.05). Conclusions: In our study, administration of 2 μg·kg−1 remifentanil before induction along with thiopental or propofol was shown to provide acceptable LMA insertion conditions at comparable levels. As hemodynamic parameters were less affected, we believe the remifentanil–thiopental combination may be a suitable alternative.
Keywords: remifentanil; propofol; thiopental; laryngeal mask airway remifentanil; propofol; thiopental; laryngeal mask airway

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MDPI and ACS Style

Akan, M.; Çakırgöz, M.; Demirel, İ.; Saraç, Ö.; Kar, A.A.; Alaygut, E.; Demirel, O.; Yeniay, H.; Tünay, A. Thiopental Versus Propofol in Combination with Remifentanil for Successful Classic Laryngeal Mask Airway Insertion: A Prospective, Randomised, Double-Blind Trial. Pharmaceuticals 2025, 18, 1173. https://doi.org/10.3390/ph18081173

AMA Style

Akan M, Çakırgöz M, Demirel İ, Saraç Ö, Kar AA, Alaygut E, Demirel O, Yeniay H, Tünay A. Thiopental Versus Propofol in Combination with Remifentanil for Successful Classic Laryngeal Mask Airway Insertion: A Prospective, Randomised, Double-Blind Trial. Pharmaceuticals. 2025; 18(8):1173. https://doi.org/10.3390/ph18081173

Chicago/Turabian Style

Akan, Mert, Mensure Çakırgöz, İsmail Demirel, Ömürhan Saraç, Aysun Afife Kar, Ergin Alaygut, Oğuzhan Demirel, Hicret Yeniay, and Abdurrahman Tünay. 2025. "Thiopental Versus Propofol in Combination with Remifentanil for Successful Classic Laryngeal Mask Airway Insertion: A Prospective, Randomised, Double-Blind Trial" Pharmaceuticals 18, no. 8: 1173. https://doi.org/10.3390/ph18081173

APA Style

Akan, M., Çakırgöz, M., Demirel, İ., Saraç, Ö., Kar, A. A., Alaygut, E., Demirel, O., Yeniay, H., & Tünay, A. (2025). Thiopental Versus Propofol in Combination with Remifentanil for Successful Classic Laryngeal Mask Airway Insertion: A Prospective, Randomised, Double-Blind Trial. Pharmaceuticals, 18(8), 1173. https://doi.org/10.3390/ph18081173

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