A Co-Induction Technique Utilizing 4% Sevoflurane Followed by 0.75 mg/kg Propofol in Elderly Patients Undergoing Minimally Invasive Procedures: A Prospective Randomized Control Study
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Sampling
2.3. Materials
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Group | Total | p-Value | ||||
---|---|---|---|---|---|---|
Propofol (n = 35) | Inhalational Sevoflurane (n = 35) | Co-Induction Group (n = 35) | ||||
Age(year) | Median (IQR) | 70 (68–73) | 71 (68–76) | 70 (66–73) | 70 (68–75) | 0.306 |
Weight (kg) | Median (IQR) | 75 (70–87) | 82 (71–90) | 79 (70–90) | 80 (70–90) | 0.789 |
Height (m) | Median (IQR) | 1.7 (1.60–1.75) | 1.7 (1.65–1.77) | 1.7 (1.67–1.77) | 1.7 (1.65–1.77) | 0.863 |
BMI (kg m−2) | Median (IQR) | 28.1 (24.4–29.6) | 27.7 (24.8–32) | 27.3 (23.7–30.5) | 27.7 (24.3–30.5) | 0.789 |
Gender | Males | 27 (77.1) | 26 (74.3) | 29 (82.9) | 82 (78.1) | 0.677 |
Females | 8 (22.9) | 9 (25.7) | 6 (17.1) | 23 (21.9) | ||
ASA score | II | 20 (57.1) | 15 (42.9) | 13 (37.1) | 48 (45.7) | 0.224 |
III | 15 (42.9) | 20 (57.1) | 22 (62.9) | 57 (54.3) | ||
Airway examination | ||||||
Mouth opening (cm) | >3 | 35 (100) | 34 (97.1) | 35 (100) | 104 (99.0) | 0.364 |
Mallampati score | 1.00 | 6 (17.1) | 9 (25.7) | 9 (25.7) | 24 (22.9) | 0.219 |
2.00 | 22 (62.9) | 19 (54.3) | 13 (37.1) | 54 (51.4) | ||
3.00 | 7 (20.0) | 7 (20.0) | 13 (37.1) | 27 (25.7) | ||
TM distance (cm) | >6 | 34 (97.1) | 34 (97.1) | 34 (97.1) | 102 (97.1) | 0.558 |
head and neck movement | NL | 35 (100) | 33 (94.3) | 35 (100) | 103 (98.1) | 0.13 |
Trachea | Central | 34 (97.1) | 35 (100) | 35 (100) | 104 (99.0) | 0.364 |
FOL View | 1 | 2 (5.7) | 3 (8.6) | 2 (5.7) | 7 (6.7) | 0.645 |
2 | 5 (14.3) | 7 (20.0) | 4 (11.4) | 16 (15.2) | ||
3 | 7 (20.0) | 3 (8.6) | 3 (8.6) | 13 (12.4) | ||
4 | 21 (60.0) | 22 (62.9) | 26 (74.3) | 69 (65.7) |
Group | Total | p-Value | ||||
---|---|---|---|---|---|---|
Propofol (n = 35) | Inhalational Sevoflurane (n = 35) | Co-Induction Group (n = 35) | ||||
Time to ball drop (sec) | Median (IQR) | 80 (60–104) | 120 (95–135) | 150 (125–165) | 120 (85–150) | <0.001 |
LMA size | 3 | 3 (8.6) | 4 (11.4) | 5 (14.3) | 12 (11.4) | 0.363 |
4 | 20 (57.1) | 12 (34.3) | 14 (40.0) | 46 (43.8) | ||
5 | 12 (34.3) | 19 (54.3) | 16 (45.7) | 47 (44.8) | ||
Number of trials for LMA insertion | 1 | 29 (82.9) | 24 (68.6) | 29 (82.9) | 82 (78.1) | 0.248 |
2 | 4 (11.4) | 10 (28.6) | 6 (17.1) | 20 (19.0) | ||
3 | 2 (5.7) | 1 (2.9) | 0 (0) | 3 (2.9) | ||
Time for LMA insertion after ball drop (sec) | Median (IQR) | 6 (5–10) | 10 (5–20) | 9 (5–10) | 8 (5–10) | 0.313 |
Time to surgery from preoxygenation (min) | Median (IQR) | 10 (8–11) | 11 (9–12) | 10 (9–11) | 10 (8–11) | 0.468 |
Respiratory adverse events | 4 (11.4) | 26 (74.3) | 4 (11.4) | 34 (32.4) | <0.001 | |
Cough | 1 (2.9) | 4 (11.4) | 1 (2.9) | 6 (5.7) | 0.204 | |
Transient apnea | 3 (8.6) | 24 (68.6) | 4 (11.4) | 31 (29.5) | <0.001 | |
Partial laryngospasm | 1 (2.9) | 6 (17.1) | 1 (2.9) | 8 (7.6) | 0.034 | |
Limb movement | 14 (40.0) | 15 (42.9) | 11 (31.4) | 40 (38.1) | 0.592 | |
Gagging | 10 (28.6) | 11 (31.4) | 10 (28.6) | 31 (29.5) | 0.955 | |
Increased salivation | 1 (2.9) | 2 (5.7) | 2 (5.7) | 5 (4.8) | 0.811 | |
Sevoflurane level | 1st minute | - | 4.4 ± 0.4 | 2.1 ± 0.3 | 3.2 ± 1.2 | <0.001 |
2nd minute | - | 5.0 ± 0.8 | 2.7 ± 0.3 | 3.8 ± 1.3 | <0.001 | |
3rd minute | - | 5.3 ± 0.4 | 3.0 ± 0.4 | 4.1 ± 1.2 | <0.001 | |
4th minute | - | 5.4 ± 0.4 | 3.2 ± 0.2 | 4.3 ± 1.2 | <0.001 | |
Need of Ephedrine during induction | 9 (25.7) | 5 (14.3) | 3 (8.6) | 17 (16.2) | 0.14 | |
Mean dose of Ephedrine among cases for which it was administered | 7.0 ± 6.2 | 8.40 ± 5.4 | 40 ± 1.7 | 0.265 |
Characteristic | Group | Total | p-Value | |||
---|---|---|---|---|---|---|
Propofol (n = 35) | Inhalational Sevoflurane (n = 35) | Co-Induction Group (n = 35) | ||||
Do you feel uncomfortable with mask sealing? | No | 32 (91.4) | 31 (88.6) | 34 (97.1) | 97 (92.4) | 0.388 |
Yes | 3 (8.6) | 4 (11.4) | 1 (2.9) | 8 (7.6) | ||
How do you feel about the gas smell? | Pleasant | 13 (37.1) | 7 (20.0) | 10 (28.6) | 30 (28.6) | 0.573 |
Neutral | 18 (51.4) | 22 (62.9) | 20 (57.1) | 60 (57.1) | ||
Unpleasant | 4 (11.4) | 6 (17.1) | 4 (11.4) | 14 (13.3) | ||
Very unpleasant | 0 (0) | 0 (0.0) | 1 (2.9) | 1 (1.0) | ||
How do you feel about the start of induction? | Pleasant | 22 (62.9) | 20 (57.1) | 22 (62.9) | 64 (61.0) | 0.451 |
Neutral | 12 (34.3) | 12 (34.3) | 13 (37.1) | 37 (35.2) | ||
Unpleasant | 1 (2.9) | 3 (8.6) | 0 (0) | 4 (3.8) | ||
Will you accept to have this method of induction again? | Definitely would like to | 26 (74.3) | 21 (60.0) | 29 (82.9) | 76 (72.4) | 0.317 |
Probably would like to | 5 (14.3) | 8 (22.9) | 5 (14.3) | 18 (17.1) | ||
Not sure | 3 (8.6) | 5 (14.3) | 0 (0.0) | 8 (7.6) | ||
Probably would not | 1 (2.9) | 1 (2.9) | 1 (2.9) | 3 (2.9) |
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Ababneh, O.A.; Suleiman, A.M.; Bsisu, I.K.; Al-Ghanem, S.M.; Samarah, W.K.; Al-Zaben, K.R.; Qudaisat, I.Y.; Khreesha, L.A.; Al Edwan, G.M.; Murshidi, M.M. A Co-Induction Technique Utilizing 4% Sevoflurane Followed by 0.75 mg/kg Propofol in Elderly Patients Undergoing Minimally Invasive Procedures: A Prospective Randomized Control Study. Medicina 2020, 56, 682. https://doi.org/10.3390/medicina56120682
Ababneh OA, Suleiman AM, Bsisu IK, Al-Ghanem SM, Samarah WK, Al-Zaben KR, Qudaisat IY, Khreesha LA, Al Edwan GM, Murshidi MM. A Co-Induction Technique Utilizing 4% Sevoflurane Followed by 0.75 mg/kg Propofol in Elderly Patients Undergoing Minimally Invasive Procedures: A Prospective Randomized Control Study. Medicina. 2020; 56(12):682. https://doi.org/10.3390/medicina56120682
Chicago/Turabian StyleAbabneh, Omar A., Aiman M. Suleiman, Isam K. Bsisu, Subhi M. Al-Ghanem, Walid K. Samarah, Khaled R. Al-Zaben, Ibraheem Y. Qudaisat, Lubna A. Khreesha, Ghazi M. Al Edwan, and Mujalli M. Murshidi. 2020. "A Co-Induction Technique Utilizing 4% Sevoflurane Followed by 0.75 mg/kg Propofol in Elderly Patients Undergoing Minimally Invasive Procedures: A Prospective Randomized Control Study" Medicina 56, no. 12: 682. https://doi.org/10.3390/medicina56120682
APA StyleAbabneh, O. A., Suleiman, A. M., Bsisu, I. K., Al-Ghanem, S. M., Samarah, W. K., Al-Zaben, K. R., Qudaisat, I. Y., Khreesha, L. A., Al Edwan, G. M., & Murshidi, M. M. (2020). A Co-Induction Technique Utilizing 4% Sevoflurane Followed by 0.75 mg/kg Propofol in Elderly Patients Undergoing Minimally Invasive Procedures: A Prospective Randomized Control Study. Medicina, 56(12), 682. https://doi.org/10.3390/medicina56120682