ProSeal Laringeal Mask in Children: Retrospective Study of 428 Cases

Year 2011, Volume: 18 Issue: 4, 248 - 251, 01.08.2011

Zekine Begeç M. Ali Erdoğan Aytaç Yücel Ülkü Özgül Nurçin Gülhaş M. Özcan Ersoy

Abstract

Aim: ProSeal LMA (LMA) was developed on the basis of the classic LMA is a supraglottic airway device. In this study, anesthesia records of 428 pediatric patients who PLMA were inserted after induction of general anesthesia in pediatric surgery between May 2009 and June 2011 were reviewed retrospectively. Material-Methods: Demographic characteristics, ASA score, type of surgery and anesthesia time, the premeditation, induction agents, positions of patients, PLMA placement technique, the number of attempts, the practitioners' experience of anesthesia and complications encountered were recorded retrospectively. Results: Anesthesia was induced intravenously or inhalationally in 355 and 73 patients, respectively. PLMA was placed at the first trial to 411 patients and at the second trial to 14 patients. 342 patients who PLMA were inserted underwent to the operation in the supine position, 86 patients had the operation in lithotomy position. PLMA was placed with digital technique to 355 patients, introducer was used in 73 patients. After PLMA was placed, in 4 patients laryngospasm, in 3 patients bronchospasm, in one patient gastric distension, in two patients hiccup developed. After placement of PLMA two patients vomited. After removal of PLMA laryngospasm developed in three patients, blood transmission at PLMA has been found in 2 patients. Conclusion: In children, PLMA with allowing high leak pressures than the classic LMA and separating glottis to esophagus, high placement success and low complication rate is an effective airway device. Key words: Proseal LMA; Children; Complication.

Keywords

Proseal LMA; Children; Complication.

Çocuklarda ProSeal Laringeal Maske: 428 Olgunun Geriye Dönük İncelenmesi

Abstract

Amaç: ProSeal Laringeal Maske (PLMA) klasik LMA temelinde geliştirilen supraglottik bir hava yolu aracıdır. Bu çalışmada Mayıs 2009 ile Haziran 2011 tarihleri arasında çocuk cerrahisi ameliyatlarında genel anestezi indüksiyonu sonrası PLMA uygulanan 428 pediyatrik hasta, anestezi kayıtları gözden geçirilerek geriye dönük olarak değerlendirildi. Gereç ve Yöntem: Çalışmaya alınan hastaların demografik özellikleri, ASA skorları, cerrahi girişim türü ve anestezi süresi, uygulanan premedikasyon, indüksiyon ajanları, hastaların pozisyonları, yerleştirilen PLMA numarası ve hangi yöntemle yerleştirildiği, girişim sayısı, uygulayıcıların anestezi tecrübeleri ve karşılaşılan komplikasyonlar kaydedildi. Bulgular: Anestezi indüksiyonu 355 hastada intravenöz, 73 hastada inhalasyon ajanlarıyla sağlanmıştır. Hastaların 411'ine birinci denemede, 14'üne ikinci denemede PLMA yerleştirilmiştir. PLMA uygulanan hastaların 342'si supin pozisyonda, 86'sı litotomi pozisyonunda operasyon geçirmiştir. 355 hastada dijital teknik ile PLMA takılırken, 73 hastada introduser kullanılmıştır. PLMA yerleştirildikten sonra 4 hastada laringospazm, üç hastada bronkospazm, bir hastada mide distansiyonu, iki hastada hıçkırık gelişmiştir. İki hasta PLMA yerleştirildikten sonra kusmuştur. PLMA çıkarıldıktan sonra üç hastada laringospazm gelişmiş, iki hastada PLMA'da kan bulaşı tesbit edilmiştir. Sonuç: Çocuklarda, PLMA başarılı yerleştirme oranı yüksek, komplikasyon oranı düşük, klasik LMA'ya göre daha yüksek kaçak basınçlarına izin veren, özefagusu glottisden ayıran etkili bir havayolu aracıdır. Anahtar kelimeler: Proseal Laringeal Maske; Çocuklar; Komplikasyon.

Keywords

Proseal Laringeal Maske; Çocuklar; Komplikasyon.

References

• Brain AIJ. The laryngeal mask. A new consept in airway management. Br J Anaesth 1983; 55: 801-5.
• Akhtar TM, Street MK. Risk of aspiration with the laryngeal mask. Br J Anaesth 1994; 72: 447-50.
• Brimacombe JR, Berry A. The incidence of aspiration associated with the laryngeal mask airway: a meta-analysis of published literature. J ClinAnesth 1995; 7: 297-305.
• Brain AİJ, Verghese C, Strube PJ. ‘’ProSeaal’’ - a laryngeal mask with an oesophageal vent. Br J Anaesth 2000; 84: 650-4.
• Cook TM, Lee G, Nolan JP. The ProSeal laryngeal mask airway: a review of the literature. Can J Anaesth 2005; 52: 739-60.
• Goldman K, Roettger C, Wulf H. The size 1½ ProSealTM laryngeal mask airway in infants: A randomized, crossover investigation with the classicTM laryngeal mask airway. Anesth Analg 2006; 102: 405-10.
• Wheeler M. ProSealTM laryngeal mask airway in 120 pediatric surgical patients: a prospective evaluation of characteristics and performance. Pediatric Anesthesia 2006; 16: 297-301.
• Begec, Z, Demirbilek S, Onal D, Erdil F, Toprak HI, Ersoy MO. Ketamine or alfentanil administration prior to PropofolAnaesthesia: The Effects on Proseal Laryngeal Mask airway insertion conditions and haemodynamic changes in children. Anaesthesia 2009; 64: 282-6,
• Lopez-Gil M, Brimacombe J. The ProSealTM laryngeal mask airway in children. Pediatric Anesthesia 2005; 15: 229-34.
• Kelly F, Sale S, Bayley G, Cook T, Stoddart P, White M. A cohort evaluation of the pediatric ProSeal laryngeal mask airway in 100 children. Pediatric Anesthesia 2008; 18: 947-51.
• Brain AIJ, McGhee TD, McAteer EJ, Thomas A, Abu-Saad MAW, Bushman JA. The laryngeal mask airway Development preliminary and trials of a new type of airway. Anaesthesia 1985; 40: 356-61.
• Brimacombe J, Berry A. The laryngeal mask airway-anatomical and physiological implications. Acta Anaesthesiaol Scand 1996; 40: 201-9.
• Brown GW, Patel N, Ellis FR. Comparison of propofol and thiopentone for laryngeal mask insertion. Anaesthesia 1991: 46: 771-2
• Uzun S, Gözaçan A, Canbay O, Ozgen S. Remifentanil and etomidate for laryngeal mask airway insertion. J Int Med Res 2007; 35: 878-85.
• Bahk JH, Sung J, Jang IJ. A comparison of ketamine and lidocaine spray with propofol for the insertion of laryngeal mask airway in children: a double-blinded randomized trial. Anesth Analg 2002; 95: 1586-9.
• Cheam EW, Chui PT.Randomised double-blind comparison of fentanyl, mivacurium or placebo to facilitate laryngeal mask airway insertion. Anaesthesia 2000; 55: 323-6.
• Goel S, Bhardwaj N, Jain K. Efficacy of ketamine and midazolam as co-induction agents with propofol for laryngeal mask insertion in children. PaediatrAnaesth 2008; 18: 628-34.
• Molloy ME, Buggy DJ, Scanlon P. Propofol or sevoflurane for laryngeal mask airway insertion.Can J Anaesth 1999; 46: 322-6.
• Akhtar TM, Street MK. Risk of aspiration with the laryngeal mask. Br J Anaesth 1994; 72: 447-50.
• Evans NR, Llewellyn RL, Gardner SV, James MF. Aspiration prevented by the ProSeal laryngeal mask airway: a case report. Can J Anaesth 2002; 49: 413-6.
• Mark DA. Protection from aspiration with the LMA-ProSeal after vomiting: a case report. Can J Anaesth 2003; 50: 78-80.
• Keller C, Brimacombe J, Kleinsasser A, Loeckinger A. Does the ProSeal laryngeal mask airway prevent aspiration of regurgitated fluid?. Anesth Analg 2000; 91: 1017-21.