Effect of General Anesthesia Induction with a Combination of Propofol and Etomidate Versus Propofol Alone on I-gel Laryngeal Mask Airway Insertion

Kanittha Nakarin; Wichuda Panomai; Apisada Butpho

Authors

Kanittha Nakarin Department of Anesthesiology, Kumphawapi Hospital
Wichuda Panomai Department of Anesthesiology, Kumphawapi Hospital
Apisada Butpho Department of Anesthesiology, Kumphawapi Hospital

Keywords:

propofol, etomidate, combination of propofol and etomidate, I-gel LMA insertion, LMA insertion conditions

Abstract

Propofol is one of the most commonly used anesthetic agents for laryngeal mask airway (LMA) insertion, but it is associated with unwanted complications such as hemodynamic instability and cardiovascular complications. Various intravenous anesthetic agents in combination with propofol have been studied in an attempt to minimize these complications. This prospective, randomized, double-blind, controlled study aimed to compare the effect of a combination of propofol and etomidate versus propofol alone on hemodynamics, LMA insertion conditions, and first- attempt success rate for I-gel LMA insertion. The participants comprised 62 adults aged 18–64 years of either sex with American Society of Anesthesiologists (ASA) physical status I-II who underwent elective surgery under general anesthesia at Kumphawapi Hospital, Udon Thani, Thailand, between May 2025 and August 2025. Patients were randomly allocated to the propofol (P) group (n=31), which received propofol 2 mg/kg, or the propofol + etomidate (PE) group, which received propofol 1 mg/kg plus etomidate 0.2 mg/kg for induction. Hemodynamic parameters were recorded before induction, 1 minute after induction, after successful LMA insertion, and 3, 5 and 10 minutes after LMA insertion. Jaw relaxation, LMA insertion conditions, and first-attempt success rate were also assessed and recorded. The results showed no significant differences in mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), or heart rate (HR) at various time points following induction between the two groups (p>0.050). Good jaw relaxation was observed in 23/31 patients (74.19%) in group P versus 19/31 patients (61.29%) in group PE (p=0.277). Overall LMA insertion conditions were comparable between groups (p=0.785). The first-attempt success rate of I-gel LMA insertion was 83.37% in group P and 90.32% in group PE (p=0.307). In conclusion, there were no significant differences between the effects of propofol 1 mg/kg combined with etomidate 0.2 mg/kg and propofol 2 mg/kg on hemodynamic stability, jaw relaxation, LMA insertion conditions, or first-attempt success rate.

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