Lale KARABIYIK, Şengül ÖZDEK, Gökçen EMMEZ

Laringoskopisiz ve Standart Laringoskopik Entübasyon Yöntemlerinin Hemodinamik Yanıtlar ve Göz İçi Basıncına Etkileri

Amaç: Laringoskopinin hemodinamik yanıt ve göz içi basıncı (GİB) artışına neden olduğu bilinmektedir. Supraglottik hava yolu araçları (SGHA) uygulandığında ise hemodinami daha stabil kalabilmektedir. Bu çalışmada laringoskopik entübasyonla, Cobra Perilaringeal Hava Yolu (Cobra-PLA) ve Entübasyonu Sağlayan Laringeal Maske Hava Yolu (ILMA) gibi SGHA’lar yardımıyla yapılan laringoskopisiz entübasyonun hemodinamik yanıtlar ve GİB’e etkilerinin karşılaştırılması amaçlanmıştır. Yöntem: Zor entübasyon hikayesi ve oftalmik patolojisi olmayan, ASA I-II, 60 hasta randomize olarak Cobra-PLA (G-PLA), ILMA (G-ILMA) ve laringoskopik entübasyon (G-L) gruplarına ayrıldı. İndüksiyon, intravenöz 0,5 mg kg-1 lidokain, 1,5-2,5 mg kg-1 propofol ve 0,6 mg kg-1 rokuronyumla sağlandı. Entübasyonu takip eden 10. dk’ya kadar, 2-4 mg kg-1 sa-1 propofol infüzyonu sürdürüldü. Entübasyon G-PLA ve G-ILMA’da, Cobra-PLA ve ILMA içinden endotrakeal tüplerin trakeaya yerleştirilmesiyle, G-L’de ise laringoskopla sağlandı. Hemodinamik parametreler ve GİB; indüksiyon, SGHA’ların yerleştirilmesi, entübasyon ve ekstübasyonun öncesi ve sonrasında kaydedildi. Bulgular: Grupların demografik özellikleri, ağız açıklıkları, tiromental mesafeleri, Mallampati skorları benzerdi. Kalp atım hızı G-L’de, entübasyon sonrasında diğer gruplardan daha yüksek bulundu (p

Effects of Non-Laryngoscopic and Standard Laryngoscopic Intubation Methodson Hemodynamic Responses and Intraocular Pressure

Objective: The effects of laryngoscopy on hemodynamic response and intraocular pressure (IOP) are well known. The use of Supraglottic Airway Devices (SGAD) provides more stable hemodynamic parameters. Aim of this study is to compare the effects of laryngoscopic intubation on hemodynamic responses and IOP with intubation using Cobra Perilaryngeal Airway (Cobra-PLA) and Intubating Laryngeal Mask Airway (ILMA), without laryngoscopy. Methods: Sixty ASA I-II patients, without history of difficult intubation or ophtalmic pathology were randomly allocated into Cobra-PLA (G-PLA), ILMA (G-ILMA), and laryngoscopic intubation (G-L) groups. Induction was achieved with intravenous lidocaine 0.5 mg kg-1, propofol 1.5-2.5 mg kg-1 and rocuronium 0.6 mg kg-1. Propofol infusion of 2-4 mg kg-1 h-1 was continued until the 10th minute following intubation. Intubation was achieved by placing endotracheal tubes through the SGAD into the trachea in G-PLA and G-ILMA, and with a laryngoscope in G-L. Hemodynamic parameters and IOP were recorded before and after induction, the placement of SGAD, before and after intubation, extubation. Results: Demographic characteristics, mouth opening, thyromental distance, and Mallampati score of the groups were similar. Heart rate was significantly higher in G-L than the other groups after intubation (p

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