Effect of small dose propofol or midazolam to prevent laryngospasm and coughing following oropharyngeal surgeries: Randomized controlled trial

Peer review under responsibility of Egyptian Society of Anesthesiologists.

Abstract

Objective

To compare the effectiveness of small dose of propofol or midazolam in treating laryngospasm following extubation in adult patients undergoing oropharyngeal operations.

Methods

The study was conducted in Al-Zahra Hospital, Al-Azhar University, Egypt. One hundred and twenty adult patients, with age range 30–50 years, ASA physical status I–II, of either sex undergoing elective oropharyngeal surgeries under general anesthesia were randomly allocated to one of three equal groups (n = 40) using a computer generated randomization table. At extubation before suction, the patients in the three groups were administered intravenously propofol 0.8 mg/kg diluted in 20 ml (Group P) or midazolam 0.05 mg/kg diluted in 20 ml (Group M) or saline 20 ml as control group (Group C). The following parameters were recorded: hemodynamic changes (heart rate and mean arterial blood pressure), the frequency and severity of laryngospasm and cough were recorded before time of extubation and up to 5 min using four point scale.

Results

Compared with the control group, there was a significant decrease in the mean arterial pressure and increase in pulse rate in both groups after administration of the study drugs and up to 5 min after extubation, and this change was comparable and similar in both groups. During emergence and up to 5 min, the incidence and severity of postoperative laryngospasm and cough were significantly lower (p < 0.05) in both propofol and midazolam groups as compared to control group. The change in both propofol and midazolam groups was insignificant and comparable.

Conclusion

We conclude that intravenous administration of small dose of propofol or midazolam before tracheal extubation decreases the incidence and severity of laryngospasm and coughing in adult patients undergoing oropharyngeal surgeries.

Keywords:

• Propofol
• Midazolam
• Postextubation
• Laryngospasm
• Cough

Notes

Peer review under responsibility of Egyptian Society of Anesthesiologists.