NURCAN DORUK, Selma BÜLBÜL, HANDAN BİRBİÇER, ZELİHA ÖZER, Özgür TÜRKMENOLU, BAHAR TAŞDELEN

LAPAROSKOPİK KOLESİSTEKTOMİ OLGULARINDA PROSEAL LARİNGEAL MASKE VE ENDOTRAKEAL TÜPÜN KAF BASINCI VE HAVAYOLU ÜZERİNE ETKİLERİNİN KARŞILAŞTIRILMASI

Amaç: Laparoskopik kolesistektomi planlanan hastalarda endotrakeal entübasyon (ETT) ve proseal laringeal maske (PLMA) uygulamasınınkaf basıncı ve havayolu üzerine etkilerinin karşılaştırılması amaçlandı. Yöntem: Çalışma genel anestezi altında laparoskopik kolesistektomi planlanan, ASA I-II, 20-70 yaş arasında toplam 41 hasta üzerinde yapıldı.Grup ETT'de (n=19) hastalara ETT, Grup PLMA'da (n=22) ise PLMA yerleştirildi. Her iki gruba da nazogastrik tüp yerleştirilerek mide içeriğiaspire edildi. Olguların demografik verileri, havayolu araçlarının yerleştirme süreleri ve girişim sayıları kaydedildi. Preoperatif, peroperatif 5., 10.,15., 30., 45., 60., 75. dakikalarda hemodinamik ve solunumsal parametreler, kaf basınçları kaydedildi. Karboperitonyum öncesi, sonrası pik havayolubasınçları ve postoperatif dönemdeki komplikasyonlar (kanama, boğaz ağrısı, yutma güçlüğü, laringospazm, bronkospazm) kaydedildi.Bulgular: Demografik veriler, güvenli havayolu sağlamak için uygulanan girişim sayıları, kaf basınçları, hemodinamik ve solunumsalparametreler her iki grupta da benzerdi. Postoperatif komplikasyonlardan boğaz ağrısı ve yutma güçlüğü görülme sıklığı ETT uygulanan gruptaistatistiksel olarak anlamlı derecede yüksekti (p

THE COMPARISON OF THE EFFECTS OF PROSEAL LARYNGEAL MASK AND ENDOTRACHEAL INTUBATION ON CUFF PRESSURE AND AIRWAY IN LAPAROSCOPIC CHOLECYSTECTOMY PATIENTS

Objective: It’s aimed to compare the effects of endotracheal intubation (ETT) and proseal laryngeal mask (PLMA) on cuff pressure and airway inthe patients planned laparoscopic cholecystectomy.Method: The study was performed in total 41 patients that ASA score I-II, aged between 20-70 years and planned laparoscopic cholecystectomyunder general anesthesia. In group ETT (n=19), ETT, in group PLMA (n=22) PLMA was placed to the patients. The gastric content was aspirated bya nasogastric tube in both of the groups. Demographic data, and attempt numbers were recorded. Hemodynamic and respiratory parameters, cuffpressures at preoperative and peroperative 5., 10., 15., 30., 45., 60., 75. minutes were recorded. Before and after carboperitoneum peak airwaypressures and complications (bleeding, sore throat, difficulty in swallowing, laryngospasm, bronchospasm) at postoperative period were recorded.Results: The demographic data, number of attempts to provide safe airway, cuff pressures, hemodynamic and respiratory parameters were similarin each groups. The incidence of postoperative complications as sore throat and difficulty in swallowing was significantly statistically high in ETTgroup (p

PDF

___

1. Maltby JR, Beriault MT, Watson NC, Liepert D, Fick GH. The LMA-ProSeal is an effective alternative to tracheal intubation for laparoscopic cholecystectomy. Can J Anaesth 2002; 49: 857-862.
2. Cook TM, Nolan JP, Verghese C, et al. Randomized crossover comparison of the ProSeal with the classic laryngeal mask airway in unparalysed anaesthetized patients. Br J Anaesth 2002; 88: 527-533.
3. Somri M, Fradis M, Malatskey S, Vaida S, Gaitini L. Simple on line endotracheal cuff pressure relief valve. Ann Otol Rhinol Laryngol 2002; 111: 190-192.
4. Karasawa F, Takita A, Kodama M, Takahashi T, Wada H. Changes in gas concentrations in the Brandt endotracheal tube cuff during and after anaesthesia with nitrous oxide. Eur J Anaesthesiol 2003; 20: 391-395.
5. Karasawa F, Matsuoka N, Kodama M, et al. Repeated deflation of a gas-barrier cuff to stabilize cuff pressure during nitrous oxide anesthesia. Anesth Analg 2002; 95: 243-248.
6. Benneth MH, Isert PR, Cumming RG. Postoperative sore throat and hoarseness following tracheal entubation using air or saline to inflate the cuff-a randomized controlled trial. Anaesth Intensive Care 2000; 28: 408-413.
7. Sengupta P, Sessler DI, Maglinger P, et al. Endotracheal tube cuff pressure in three hospitals, and the volume required to produce an appropriate cuff pressure. BMC Anesthesiol 2004; 29: 8.
8. Mol DA, De Villers Gdu T, Claassen AJ, Joubert G. Use and care of an endotracheal/tracheostomy tube cuff-are intensive care unit staff adequately informed? S Afr J Surg 2004; 42: 14-16.
9. Buharal› Z, Altan A, Türkmen A, Turgut N. Laparaskopik kolesistektomi cerrahisinde Proseal laringeal mask ve endotrakeal entübasyonun karfl›laflt›r›lmas›. Türk Anest Rean Der 2007; 35: 405-412.
10. Y›ld›r›m ZB, Uzunkoy A, Çi¤dem A, Ganida¤l› S, Özgönül A. Changes in cuff pressure of endotracheal tube during laparoscopic and open abdominal surgery. Surg Endosc 2012; 26: 398-401.
11. Kul N, Tezcan B, Çetintafl Y, ‹fller D, Durak P, Erdemli Ö. Pnömoperitonyum ve hasta pozisyonun endotrakeal tüp kaf bas›nc› üzerine etkileri. Türk Anest Rean Der Dergisi 2005; 33: 406-410.
12. Maltby JR, Beriault MT, Watson NC, Liepert DJ, Fick GH. LMAClassic and LMA-ProSeal are effective alternatives to endotracheal intubation for gynecologic laparoscopy. Can J Anesth 2003; 50: 71-77.
13. Keller C, Brimacombe J, Kleinsasser A, Brimacombe L. The laryngeal mask airway ProSeal (TM) as a temporary ventilatory device in grossly and morbidly obese patients before laryngoscopeguided tracheal intubation. Anesth Analg 2002; 94: 737-740.
14. Ovat E, Örki TK, Güzelmeriç F,Gürcü E, Koçak T. Laparoskopik kolesistektomide endotrakeal entübasyon veya Proseal Laringeal Maske uygulamas›n›n hemodinami, ventilasyon ve gastrik distansiyon üzerine etkileri. Anestezi Dergisi 2012; 20: 99-102.
15. Mandoe H, Nikolajsen L, Lintrup U, Jepsen D, Molgaard J. Sore throat after endotracheal intubation. Anesth Analg 1992; 74: 897-900.
16. Hahnel J, Treiber H, Konrad F, et al. A comparison of differ-ent endotracheal tubes. Tracheal cuff seal, peak centering and the incidence of postoperative sore throat. Anaesthesist 1993; 42: 232-237.
17. Pelc P, Prigogine T, Bisschop P, Jortay A. Tracheoesopha-geal fistula: case report and review of literature. Acta Oto-rhinolaryngol Belg 2001; 55: 273-278.
18. Liu H, Chen JC, Holinger LD, Gonzalez-Crussi F. Histo-pathologic fundamentals of acquired laryngeal stenosis. Pediatr Pathol Lab Med 1995; 15: 655-677.
19. Evrard C, Pelouze GA, Quesnel J. Iatrogenic tracheal and left bronchial stenoses. Uncommon complication of Car-lens tube. Apropos of a case surgically treated in a single stage. Ann Chir 1990; 44: 149-156.
20. Higgins PP, Chung F, Mezei G. Postoperative sore throat after ambulatory surgery. Br J Anaesth 2002; 88: 582-584.
21. Mizutamari E, Yano T, Ushij›ma K, et al. A comparison of postoperative sore throat after use of laryngeal mask airway and tracheal tube. J Anesth 2004; 18: 151-155.
22. Shroff P, Surekha K. Randomized comparative study between the proseal laryngeal mask airway and the endotracheal tube for laparoscopic surgery. Internet J Anesthesiol 2006; 11. [Last accessed on 2010 Jul 9].
23. Saraswat N, Kumar A, Mishra A, Gupta A, Saurabh G, Srivastava U. The comparison of Proseal laryngeal mask airway and endotracheal tube in patients undergoing laparoscopic surgeries under general anaesthesia. Indian J Anaesth 2011; 55: 129-134.