Effect of Intranasal Remifentanil versus Lidocaine on Facilitation of Laryngeal Mask Airway Insertion and Cardiovascular Response: A Double-blind Clinical Trial Study

This study aimed to assess and compare the effects of intranasal administration of lidocaine andremifentanil on the condition of LMA insertion and cardiovascular response. From March 2019 to March 2020, this double-blind randomized clinical trial study was conductedon 60 patients, who underwent general anesthesia with LMA insertion at Faiz Hospital, Isfahan, Iran. Afterinduction of anesthesia and before placing the laryngeal mask, the first group received remifentanil 1 μg/Kg,the second group received lidocaine 2% 1 mg/Kg, and the third group received normal saline with the samevolume intranasally. The conditions of LMA insertion and hemodynamic changes that occurred during itsinsertion were investigated. In terms of demographics characteristics (p>0.05), success in placing the LMA on the first try(p=0.73), number of attempts to insert LMA (p=0.61), performance of LMA (p=0.73), need for additionalpropofol (p=0.53), frequency of gagging (p=0.53), cough (p=0.15) p), and laryngospasm (p=0.99) did notdiffer significantly. In the remifentanil group, the cardiovascular response to LMA injection was less than thatof the lidocaine group. Moreover, both groups were lower than the saline group, but no significant differencewas observed In facilitating LMA insertion, the effect of intranasal remifentanil was comparable to intranasallidocaine. Intranasal remifentanil was somewhat more effective than intranasal lidocaine in weakening thecardiovascular response to LMA insertion, but it did not outperform lidocaine.