ERKAN TOMATIR, Simay SERİN, Ercan GÜRSES, Bahadır SAVAŞ, Canan BALCI, Mustafa GÖNÜLLÜ

Entübasyon amaçlı laringeal maske (Fastrach) ile standart laringoskopinin karşılaştırılması

Yeni ve entübasyon amaçlı bir laringeal maske modifikasyonu olan fastrach ile standart laringoskopiyi karşılaştırmayı amaçladık. Etik kurul onayı ile ASA I-II sınıfı 60 erişkin hasta rastgele iki gruba ayrılarak, fastrach ya da standart laringoskopik entübasyon uygulandı. Entübasyon süresi, entübasyon girişimi sayısı, bleyd ya da laringeal maske üzerinde kan bulaşığı olup olmadığı kaydedildi. Sistolik ve diastolik kan basınçları, kalp hızı ve periferik oksijen satürasyonu izlendi. Fastrach grubunda laringoskopik entübasyon grubuna göre entübasyon süresi (sırayla 34.2±6.5, 16.7±2 sn) ve entübasyon girişimi sayısı (sırayla 1.4±0, ve 1.1±0.1) anlamlı düzeyde yüksek bulunurken (p

Anahtar Kelimeler:

Larinks maskeleri, Laringoskopi, Entübasyon, intratrakeal

A comparison of intubating laryngeal mask (Fastrach) with standard laryngoscopy

We aimed to compare fastrach, which is a new modified laringeal mask with standart laryngoscopy. After obtaining ethic committee approval, 60 ASA I-II adult patients were randomly divided into two groups. Either blind endotracheal intubation through fastrach or intubation with laryngoscopy were performed. The time for intubation, the number of attempts required for successful intubation and blood on on the laryngeal mask or blade were recorded. Systolic and diastolic blood pressures, heart rate and peripheral oxygen saturation were monitored. It was founded that the time for intubation and the number of attempts required for successful intubation were significantly higher in fastrach group than laryngoscopy group (p<0.05), respectively 34.2+6.5, 16.7+2 seconds and 1.4+0: 1.1+0.1). The groups were similar with respect to blood on laryngeal mask or blade, respectively (6/30: 2/30). İntubation was performed with laryngoscopy in two cases whom were failed to be intubated vie fastrach. But all of patients were intubated in the laryngoscopy group. In fastrach group, systolic and diastolic blood pressures, and heart rate reduced after intubation. (p<0.05) We concluded that the technique of blind intubation through fastrach is time-consuming, but it provides more hemodynamic stability and might be an alternative in patients needed hemodynamic stabilization during intubation.

Keywords:

Laryngeal Masks, Laryngoscopy, Intubation, Intratracheal,

___

1. Brain AI. The laryngeal mask. A new concept in airway management. Br J Anaesth 1983: 55: 801-4.
2. Verghese C, Smith TGC, Young E. Survery of laryngeal maskairway usega in 11910 patients: Safety and efficacy for conventional and nonconventional usage. Anesth Analg 1996; 82: 129-35.
3. Eti Z. Işık D, Yalçınkaya D, Göğüs FY. 2360 hastada laringeal maske uygulamasının retrospektif analizi. Türk Anest Rean Cem Mecmuası 1998: 26: 392-54.
4. Heath M, Allagain J. Intubation through the laryngeal mask: A technique for unexpected difficult intubation. Anaesthesia 1991:46: 545-8.
5. Brain AI, Verghese C, Addy EV. Kapila A. The intubaling laryngeal mask. I: Development of a new device for intubation of the trachea. Br J Anaesth 1997; 79: 699-703.
6. Kapila A, Addy EV, Verghese C. Brain AI. The intubating laryngeal mask: an intial assessment of performance. Br J Anaesth 1997:79:710-3.
7. Joe H, Rose K, Fastrach, a new iaryngeal mask airway: successful use in patients with difficult airways. Can J Anaesth 1998:45:253-6.
8. Doğu H, Erkal H. Özyurt Y, Konakçı M. Öcal Z. Arıkan Z. Zor entübasyonlara yaklaşım (3 olgu nedeniyle). Türk Anest Rean Cem Mecmuası 1998; 26: 406-8.