MESUT ŞENER, Elif A. AKPEK, Gülnaz ARSLAN

Kısa süreli cerrahi girişimlerde "Kaflı orofaringeal havayolu" ve "Laringeal maske" uygulaması

Bu çalışmada; kısa süreli cerrahi girişimlerde havayolu açıklığının sağlanmasında alternatif bir yöntem olarak yeni bir uygulama olan "kaflı orofaringeal havayolu" (KOHY) sunulmaktadır. Çalışmamızda KOHY kullanımı intraoperatif ve erken postoperatif deneyimler açısından "laringeal maske " (LM) ile prospektif randomize olarak karşılaştırılmışım Uygulama esnasında ve sonlandırılırken olguların verdikleri havayolu reaksiyonu açısından gruplar arasında fark bulunmadı. Havayolu açıklığının idamesinde apne periyodunda ventilasyonu sağlamak için KOHY grubunda daha sık baş ve/veya çene manevrasına gereksinim duyuldu. Postoperatif dönemde ise lokal komplikasyonlar KOHY grubunda anlamlı olarak düşük kaydedildi. Sonuç olarak; kısa süreli cerrahi girişimlerde yaygın olarak kullanılan LM'ye KOHY kullanımının alternatif bir yöntem olabileceği kanısına varılmıştır.

Anahtar Kelimeler:

Cerrahi aletler, Larinks maskeleri, Anestezi, genel, İntraoperatif komplikasyonlar, Ameliyat sonrası komplikasyonlar, Cerrahi işlemler, elektif

Application of cuffed oropharyngeal airway and laryngeal mask airway in short surgical procedures

"Cuffed oropharyngeal airway" (COPA) has been introduced as an alternative method of airway maintenance in surgical procedures of short duration. In this prospective randomized study, COPA was compared with "laryngeal mask airway" (LMA) in respect to the intraoperative and early postoperative practice. During applications and the emergence periods, airway reactions of the patients did not show significant differences between the groups. Patients in the COPA group required more head and/or chin maneuvers to provide adequate ventilation during the apnea period of airway maintenance than the other group. In the early postoperative period, local complications were significantly lower in the COPA group than the LMA group. In conclusion, during surgical procedures of short duration COPA was found to be an alternative method for airway maintenance.

Keywords:

Surgical Instruments, Laryngeal Masks, Anesthesia, General, Intraoperative Complications, Postoperative Complications, Surgical Procedures, Elective,

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1. Casati A, Fanelli G, Casaletti E, et al. The target plasma concentration of propofol required to place laryngeal mask versus cuffed oropharyngeal airway. Anesth Analg 1999; 88: 917-20.
2. Brimacombe JR, Brirnacombe JC, Berry AM, et al. A comparison of the laryngeal mask airway and cuffed oropharyngeal airwav in anesthetized adult patients. Anesth Analg 1998;87: 147-52".
3. Nakata Y, Goto T, Saito H, et al. The placement of the cuffed oropharyngeal airway with sevoflurane in adults: a comparison with the laryngeal mask airway. Anesth Analg 1998; 87: 143-6,
4. Greenberg RS, Brimacombe J, Berry A, et al. A randomized controlled trial comparing the cuffed oropharyngeal airway and the laryngeal mask airway in spontaneously breathing anesthetized adults. Anesthesiology 1998; 88: 970-7.
5. Greenberg RS, Toting T. The cuffed oropharyngeal airway- a pilot study. Anesthesiology 1992; 77: A558.
6. Brimacombe JR, Berry AM. Mallampati grade and laryngeal mask placement. Anesth Analg 1996; 82: 1112-3.
7. Matta BF, Marsh DS. Nevin M, Laryngeal mask airway: a more successful method of insertion. J Clin Anesth 1995; 7: 132-5.
8. Maltby JR, Loken RG, Watson NC. The laryngeal mask airway: clinical appraisal in 250 patients. Can J Anaesth 1990; 37: 509-13.
9. Tagaito Y, Isono S, Nishino T. Upper airway reflexes during acombination of propofol and fentanyl anesthesia. Anesthesiology 1998; 88: 1459-66.
10. Voyagis GS, Dimitriou VK, Kyriakis KP. Comparative evaluation of the prolonged use of the cuffed oropharyngeal airway and the laryngeal mask airway in spontaneously breathing anaesthetized patients. Eur J Anaesthesiol 1999; 16: 371-5.
11. Hsu YW, Pan MH, Huang CJ, et al. Comparison of the cuffed oropharyngeal airway and the laryngeal mask airway in spontaneous breathing anaesthesia. Acta Anaesthesiol Sin 1998; 36: 187-92.
12. Ezri T, Ady N, Szmuk P, et al. Use of cuffed oropharyngeal vs laryngeal mask airway in elderly patients. Can J Anaesth 1999; 46: 363-7,
13. Wakeling HG, Butler PJ, Baxter PJC. The laryngeal mask airway: a comparison between two insertion techniques. Anesth Analg 1997; 85: 687-90.
14. Burgard G, Mollhoff T, Prien T. The effect of laryngeal mask pressure on postoperative sore throat incidence. J Clin Anesth 1996; 8: 198-201.
15. Keller C, Sparr HJ, Brimacombe J. Laryngeal mask lubrication- a comparative study of saline versus 2% lignocaine gel with cuff pressure control. Anaesthesia 1997; 52: 592-6,
16. Dingley J, Whitehead MJ. A comparative study of the incidence of sore throat with the laryngeaf mask airway. Anaesthesia 1994; 49: 251-4.