Geriatrik dişsiz hastalarda: (Sniffing) Koklama Pozisyonunda ve Laringoskop Klavuzlu Laringeal Maske Yerleştirme Yöntemlerinin Hava Yolu Yerleşim Koşullarının Ve Postoperatif Etkilerinin Karşılaştırılması

Abstract

Giriş ve Amaç: Laringeal maske(LMA), hava yolunu başarılı bir şekilde güvence altına alabilen bir supraglottik hava yolu cihazıdır. Yaşlanan bir popülasyon da, yaşlı hastalarda karmaşık cerrahi müdahaleler gerçekleştirilir. Bu çalışmanın amacı, dişsiz geriatrik hastalarda kör teknikte veya laringoskop yardımıyla LMA ProsealTM yerleştirme başarısını fiberoptik bronkoskop ile; Brimacombe skorlaması ve Campbell kategorileri sonucunu karşılaştırmaktır. Gereç ve Yöntemler: Elektif ürolojik cerrahi geçirecek LMA ProsealTM yerleştirme endikasyonu olan, 60-85 yaş arasında 50 Amerikan Anestezistler Derneği (ASA) I-III dişsiz hasta yazılı bilgilendirilmiş onam alındıktan sonra çalımaya dahil edildi. Hastalar rastgele iki gruba ayrıldı. LMA ProsealTM, kör teknik kullanılarak veya laringoskop kullanılarak yerleştirildi. ProsealTM laringeal maske hava yolu yerleştirme değerlendirmesinde Brimacombe skorlaması ve Campbell kategorilerini kullandık. Fiberoptik değerlendirmeleri, yerleştirme sürelerini, yerleştirme kolaylığını, tiromental mesafeyi, boyun kalınlığını, kesici dişler arası mesafeyi ve eksik diş sayısını karşılaştırdık. Ayrıca Young kriterlerini, tidal hacimleri, tepe basıncını, postoperatif hava yolu morbiditesini, komplikasyonları ve hemodinamik değişkenleri karşılaştırdık. Sonuçlar: PLMA yerleştirme süresi kör teknik grubunda laringoskop kullanımına göre daha kısaydı (p<0,005). Gruplar arasında Brimacombe skorlaması ve Campbell kategorileri arasında fark yoktu. Ayrıca postoperatif hava yolu morbiditesi, komplikasyonlar ve hemodinamik değişkenlerde fark bulunamadı. Sonuç: Geriatrik dişsiz hastalar PLMA yerleştirme için daha hızlı, daha kolay ve daha basit bir seçeneğe ihtiyaç duymaktadır. PLMA yerleştirmenin en uygun seçeneği, Brimacombe skorlaması ve Campbell kategorileriyle doğrulanan kör teknik olarak düşünülebilir.

Keywords

• Laringeal maske
• laringoskop
• geriatrik
• kör teknik
• fiberoptik değerlendirme

Brimacombe scoring and Campbell categories in assessment of ProsealTM laryngeal mask airway insertion in edentulous geriatric patients: blind technique vs use of laryngoscope

Abstract

Abstract Background: A laryngeal mask airway is a supraglottic airway device that can successfully secure the airway. In an aging population, complicated interventions are performed in elderly patients. The aim of this study was to compare the success of inserting the ProSeal™ laryngeal mask airway (P-LMA) with the blind technique versus with the help of a laryngoscope. We used the fiber-optic assessments with edentulous geriatric patients. Material and Methods: We obtained written informed consent from participants. The study included 50 American Society of Anesthesiologists physical status I-III edentulous patients between 60 and 85 years of age who were undergoing elective urological surgery with an indication of P-LMA placement. Patients were randomly divided into two groups. The P-LMA was inserted with the blind technique or with the assistance of a laryngoscope. We used Brimacombe scoring and Campbell categories to assess the ProSeal™ laryngeal mask airway insertion. We compared the fiber-optic assessments, insertion times, ease of insertion, thyromental distance, neck thickness, interincisor distance, and number of missing teeth. We also compared Young’s criteria, tidal volumes, peak pressure, postoperative airway morbidity, complications, and hemodynamic variables. Results: The P-LMA insertion time was shorter in the blind technique group than in the laryngoscope-assisted group. Fiberoptic scoring’s did not differ between groups, and no difference was found in postoperative airway morbidity, complications, or hemodynamic variables. Conclusion: Geriatric edentulous patients require a faster, easier, and simpler option for P-LMA insertion. The blind technique is the most appropriate choice for P-LMA insertion, as verified by Brimacombe scoring and Campbell categories.

Keywords

• laryngeal mask airway
• blind technique
• laryngoscope
• fiber-optic assessment
• geriatric

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