Septorinoplasti operasyonlarında ProSeal laryngeal maske ve entübasyon tüpünün karşılaştırılması

Year 2021, Volume: 46 Issue: 4, 1468 - 1477, 30.12.2021

Dilek Yeniay Bahanur Çekiç

https://doi.org/10.17826/cumj.978120

Abstract

Amaç: Bu çalışmada amacımız elektif septorinoplasti operasyonunda ProSeal laryngeal maske havayolu (PLMA) ve endotrakeal tüp (ETT) kullanmak ve uygulama sırasında ortaya çıkan hemodinamik farklılıkları ve postoperati ve komplikasyonları karşılaştırmaktır.
Gereç ve Yöntem: Prospektif planlı çalışmada ASA I-II ve 18-35 yaş arası 60 hasta rastgele iki gruba ayrıldı (n=30,n=30). Standart anestezi tekniğinin ardından Grup E’ye ETT, Grup P’ye PLMA yerleştirildi. Hastaların demografik özellikleri, doğru yerleştirme girişimleri, hemodinamik değişiklikler, ameliyat sonrası bulantı, kusma, boğaz ağrısı, ses kısıklığı, yutma güçlüğü ve cerrahi memnuniyet değerlendirildi.
Bulgular: Anestezi indüksiyonu sonrası 1. dk, havayolu yerleşimi sonrası 1., 2., 3., 4., 5. ve 10.dk ve ekstübasyon sonrası 3.dk kalp hızı Grup E'de Grup P'ye göre daha yüksekti. Postoperatif yutma güçlüğü Grup E'de Grup P'ye göre daha yüksekti. Cihazların yerleştirme oranları benzerdi. Grup E'de Grup P'ye göre cerrahi memnuniyet daha yüksekti. Operasyon sırasında her iki grupta da yeterli tidal volüm sağlandı.
Sonuç: Günübirlik yapılan septorinoplasti operasyonlarında havayolu yönetiminde PLMA kullanımının ETT kullanımına göre daha az hemodinamik yanıt oluşturduğunu, daha az havayolu komplikasyonu görüldüğünü ve esnekliği sayesinde cerrahi alana müdahale etmediğini saptadık. Havayolu cihazlarının yerleştirilmesi deneyimli hekimler tarafından yapıldığında PLMA, ETT'ye alternatif olabilir.

Keywords

Endotrakeal entübasyon, laryngeal maske havayolu, rinoplasti

Comparison of the ProSeal laryngeal mask airway and endotracheal tube in septorhinoplasty surgery

Abstract

Purpose: The aim of this study is to use ProSeal laryngeal mask airway (PLMA) and endotracheal tube (ETT) in elective septorhinoplasty operation and to compare the hemodynamic differences and postoperative complications during the application.
Materials and Methods: In the prospective planned study, ASA I-II and 60 patients aged 18-35 were randomly allocated into two groups (n = 30, n = 30). After the standard anesthesia technique, Group E was placed ETT, Group P PLMA. Patients’ demographic characteristics, number of attempts for correct insertion, hemodynamic changes, postoperative nausea, vomiting, sore throat, hoarseness, dysphagia and surgical satisfaction evaluated.
Results: Heart rate was higher in Group E than in Group P at the 1st min after anesthesia induction, at the 1st, 2nd, 3rd, 4th, 5th, and 10th min after airway insertion, and at the 3rd min after extubation. Difficulty in swallowing at postoperative was higher in Group E than in Group P. Insertion rates of the devices, were similar. Surgical satisfaction was higher in Group E than in Group P. Adequate tidal volume was provided in both groups during the operation.
Conclusion: The use of PLMA in airway management in outpatient septorhinoplasty operations creates less hemodynamic response compared to the use of ETT, less airway complications are seen and thanks to its flexibility, it does not interfere with the surgical area. PLMA may be an alternative to ETT when the insertion of the airway devices is performed by experienced physicians.

Keywords

Endotracheal intubation, laryngeal mask airway, rhinoplasty

References

• [1] Cook TM, Lee G, Nolan JP. The ProSeal laryngeal mask airway: a review of the literature. Can J Anesth 2005;52:739–60.
• [2] Natalini G, Lanza G, Rosano A, Dell’Agnolo P, Bernardini A. Standard Laryngeal Mask Airway and LMA-ProSeal during laparoscopic surgery. J ClinAnesth 2003;15(6):428-32. http://dx.doi.org/10.1016/S0952-8180(03)00085-0
• [3] Kaplan, A., Crosby, G. J., & Bhattacharyya, N. (2004). Airway Protection and the Laryngeal Mask Airway in Sinus and Nasal Surgery. The Laryngoscope, 114(4), 652–655. doi:10.1097/00005537-200404000-00010
• [4] Wheeler M. Proseal laryngeal mask airway in 120 pediatric surgical patients: a prospective evaluation of characteristics and performance. Pediatric Anesthesia 2006;16:297–301.
• [5] Cukurova I, Cetinkaya EA, Mercan GC, Demirhan E, Gumussoy M. Retrospective analysis of 697 septoplasty surgery cases: packing versus trans-septal suturing method.ActaOtorhinolaryngol Ital. 2012;32:111–4.
• [6]Karbasforushan A, Hemmatpoor B, Makhsosi BR, Mahvar T, Golfam P, Khiabani B. The effect of pharyngeal packing during nasal surgery on the incidence of post operative nausea, vomiting, and sore throat. Iran J Otorhinolaryngol 2014;26:219–23.
• [7] Tulunay M, Tulunay FC.Assessment of pain and measurements of pain. İn: Erdine S. (ed). Pain. 1. Edition. Istanbul, Nobel bookstore; 2000: 91-110.
• [8] Tural K. Comparison of the Efficiency and Complications of Laryngeal Mask Airway and Cobra Perilaryngeal Airway in Short-Term Surgeries.tez2.yok.gov.tr 2008.
• [9] Doksrod S, Lofgren B, Nordhammer A, Svendsen MV, Gisselsson L, Raeder J. Reinforced laryngeal mask airway compared with endotracheal tube for adenotonsillectomies. Eur J Anaesthesiol 2010;27:941–6.
• [10].HashemJarineshin 1; SaeedKashani 1; MajidVatankhah 1; AlirezaAbdulahzadeBaghaee 1; SaharSattari 1; FereydoonFekrat 1. Better Hemodynamic Profile of Laryngeal Mask Airway Insertion Compared to Laryngoscopy and Tracheal Intubation. Iran Red Crescent Med J. 2015 August; 17(8): e28615.
• [11]DurmuşKocaaslan FN, Bayramiçli M.Patient analysis and planning in aesthetic rhinoplasty. Vargel İ, editor.Nasoplasty in Every Aspect.1st Edition. Ankara: Turkey Clinics; 2019. p.7-12.
• [12]Aziz L. Bashir K. Comparison of armoured laryngeal mask airway with endotracheal tube for adenotonsillectomy. J Coll Physicians Surg Pak 2006;16:685–8.
• [13] GürcanGüngör, PervinSutaşBozkurt, LaleYüceyar. Comparison of classic, and ProSeal laryngeal mask airways (LMA) in pediatric patients. Izmir Dr. BehçetUz Children's Hospital Journal2016; 6(1):46-52 Clinical Research doi:10.5222/buchd.2016.046
• [14] Garg R, Verma S. Cobra perilaryngeal airway for thyroid surgery in a hypertensive patient. J Anesth 2009;23:469–70.
• [15] Kannan S, Harsoor SS, Sowmiya L, Nethra SS, DevikaRani D, Sathesha M. Comparison of ventilatory efficacy and airway dynamics between ProSeal laryngeal mask airway and endotracheal tube in adult patients during general anesthesia. J AnaesthesiolClinPharmacol 2015;31:517–21.
• [16] Hohlrieder M, Brimacombe J, von Goedecke A, Keller C. Postoperative nausea, vomiting, airway morbidity, and analgesic requirements are lower for the ProSeal laryngeal mask airway than the tracheal tube in females undergoing breast and gynaecological surgery. Br J Anaesth2007;99:576–80.
• [17]Ovat E, Örkei TK, Güzelmeriç F, Gürcü E, Koçak T. Effects of endotracheal intubation or proseal laryngeal mask application on hemodynamics, ventilation and gastric distension in laparoscopic cholecystectomy. Journal of Anesthesia 2012;20:99–102.
• [18] Leena G, Sambhram S, Shivam G. A prospective, randomized comparative study for use of proseal laryngeal mask airway as an alternative to endotracheal intubation for airway management in children under general anesthesia. Indian J Clinical Anaesth 2016;3:80–4.
• [19] Tekin M, Kati I, Tomak Y, Yuca K. Comparison of the effects of room air and N2O+O2 used for ProSeal LMA cuff inflation on cuff pressure and oropharyngeal structure. J Anesth 2008;22:467–70.
• [20] Hohlrieder M, Brimacombe J, Eschertzhuber S, Ulmer H, Keller C. A study of airway management using the ProSeal LMA laryngeal mask airway compared with the tracheal tube on postoperative analgesia requirements following gynaecological laparoscopic surgery. Anaesthesia 2007;62:913–8.
• [21] McHardy FE, Chung F. Postoperative sore throat: cause, prevention and treatment. Anaesthesia 1999;54:444–53.