Laparoskopik Kolesistektomide Pozitif Basınçlı Ventilasyon Sırasında Baska Mask, Proseal LMA ve I Gel ile Prospektif Randomize Karşılaştırmalı Bir Çalışma

Amaç: Proseal LMA ve I gel gibi gastrik aspirasyon avantajı olan supraglottik hava yolu araçları, laparoskopik ameliyatlarda pozitif basınçlı ventilasyonda başarıyla kullanılmaktadır. Kendiliğinden yerleşen membranöz cuff ve etkin sıvı drenaj sistemi gibi pek çok benzersiz özelliğe sahip yeni bir cihaz olan Baska mask, perilarengeal yerleşme basıncının, artan hava yolu basınçları ile aşamalı olarak artacağı şekilde tasarlanmıştır. Ancak, Baska maskın, laparoskopik ameliyatlarda kullanımı kapsamlı olarak araştırılmamıştır. Laparoskopik kolesistektomide pozitif basınçlı ventilasyon sırasında Baska mask (B), Proseal LMA (P) ve I Gel (I)’in etkinliği karşılaştırıldı. Yöntem: Laparoskopik kolesistektomi planlanan ASA I-II 90 hasta, üç gruba (B, I, P) randomize edildi. Çalışma 88 (B-30, I-29, P-29) hasta ile sürdürüldü. Orofarengeal kaçak basıncı, yerleştirme zamanı, etkin hava yolu zamanı ve hava yolu morbiditesi değerlendirildi ve üç grup karşılaştırıldı. İstatistiksel analizde; ortalama, standart sapma, paired sample t-testi, Tukey Post-Hoc testi ile tek yönlü ANOVA kullanıldı. Bulgular: Yerleştirme sırasında orofarengeal kaçak basıncı, B grubunda 38.33±4.353 cmH2 0, I grubunda 30.57±2.174 cmH2 0, P grubunda 29.36±2.706 cmH2 0 idi. Kaçak basıncı, B grubu ve diğer gruplar arasında istatistiksel olarak anlamlıydı. Sonuç: Baska mask, diğer iki supraglottik araç ile karşılaştırıldığında daha yüksek orofaringeal kaçak basıncı sağladı. Bu çalışmada kullanılan üç farklı ikinci kuşak supraglottik hava yolu aracı arasında, Baska mask, yüksek orofarengeal kaçak basıncı ile yeterli ventilasyonun sağlanmasında daha etkin bulunmuştur.

A Prospective Randomized Comparative Study between Baska Mask, Proseal LMA and I Gel During Positive Pressure Ventilation in Laparoscopic Cholecystectomy

Objective: Supraglottic airway devices with facility for gastric suction such as Proseal LMA and Igel have been successfully used for positive pressure ventilation in laparoscopic surgeries. Baskamask, a novel device with many unique features such as self-sealing membranous cuff and effective sump drainage system was designed in such a way that the perilaryngeal seal increasesincrementally with increasing airway pressures. But Baska mask was not extensively evaluated tovalidate its use in laparoscopic surgeries. The efficiency of Baska mask (B), Proseal LMA (P) and IGel (I) are compared during positive pressure ventilation in laparoscopic cholecystectomy.Methods: Ninety patients of ASA physical status I-II planned for laparoscopic cholecystectomywere randomized into three groups (B, I, P) of 30 each. The study was proceeded with 88 (B-30,I-29, P-29) patients. Oropharyngeal leak pressure, insertion time, effective airway time and airway morbidity were assessed and compared between the three groups. Mean, standard deviation, paired sample t-test, one way ANOVA with Tukey’s Post-Hoc test was used.Results: The oropharyngeal leak pressure at insertion time was 38.33±4.353 cm of H2O for groupB, 30.57±2.174 cm of H2O for group I, 29.36±2.706 cm of H2O for group P. The leak pressure wasstatistically significant between group B and other groups.Conclusions: Baska mask provided higher oropharyngeal leak pressure in comparison to othertwo supraglottic devices.

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