Tülay HOŞTEN, Tülay Şahin YILDIZ, Alparslan KUŞ, Mine SOLAK, Kamil TOKER

Comparison of Supreme Laryngeal Mask Airway and ProSeal Laryngeal Mask Airway during Cholecystectomy

Objective: This study compared the safety and efficacy of the Supreme Laryngeal Mask Airway (S-LMA) with that of the ProSeal-LMA (P-LMA) in laparoscopic cholecystectomy. Material and Methods: Sixty adults were randomly allocated. Following anaesthesia induction, experienced LMA users inserted the airway devices. Results: Oropharyngeal leak pressure was similar in groups (S-LMA, 27.8&plusmn;2.9 cmH20; P-LMA, 27.0&plusmn;4.7 cmH20; p=0.42) and did not change during the induction of and throughout pneumoperitoneum. The first attempt success rates were 93% with both S-LMA and P-LMA. Mean airway device insertion time was significantly shorter with S-LMA than with P-LMA (12.5&plusmn;4.1 seconds versus 15.6&plusmn;6.0 seconds; p=0.02). The first attempt success rates for the drainage tube insertion were similar (P-LMA, 93%; S-LMA 100%); however, drainage tubes were inserted more quickly with S-LMA than with P-LMA (9.0&plusmn;3.2 seconds versus 14.7&plusmn;6.6 seconds; p=0.001). In the PACU, vomiting was observed in five patients (three females and two males) in the S-LMA group and in one female patient in the P-LMA group (p=0.10). Conclusion: Both airway devices can be used safely in laparoscopic cholecystectomies with suitable patients and experienced users. However, further studies are required not only for comparing both airway devices in terms of postoperative nausea and vomiting but also for yielding definitive results. Turkish Anahtar Kelimeler: Laparaoskopik kolesistektomi, supraglottik havayolu gereçleri, laringeal maske havayolu, proseal, supreme Amaç: Bu çalışmada laparoskopik kolesistektomide Supreme Laringeal Maske Havayolu (S- LMA) ve Proseal Laringeal Maske Havayolunun (P-LMA) güvenilirliği ve etkinliği karşılaştırılmıştır. Meteryal metod: 60 yetişkin hasta rastgele seçildi. Anestezi indüksiyonunu takiben, tecrübeli LMA kullanıcıları tarafından hava yolu gereçleri yerleştirildi. Bulgular: Orofarengeal kaçak basınçları iki grupta da benzerdi (S-LMA, 27.8&plusmn;2.9 cmH20; P-LMA, 27.0&plusmn;4.7 cmH20; p=0.42) ve pnömoperitonum başlangıcında ve pnömoperitonum süresince değişmedi. İlk denemede yerleştirme başarısı S-LMA ve P-LMA ile %93 idi. Ortalama hava yolu gereci yerleştirme süresi, S- LMA ile P-LMA dan anlamlı olarak daha kısaydı. (12.5&plusmn;4.1 saniye, 15.6&plusmn;6.0 saniye; p=0.02). Drenaj tüpünü ilk denemede yerleştirme başarısı benzer olmasına rağmen ( P-LMA %93; S- LMA %100), S-LMA da drenaj tüpü P-LMA dan daha kısa sürede yerleştirildi (9.0&plusmn;3.2 saniye, 14.7&plusmn;6.6 saniye; p=0.001). Anestezi sonrası bakım ünitesinde, S- LMA grubunda 5 hastada (3 kadın, 2 erkek), P-LMA grubunda ise 1 kadın hastada kusma gözlendi (p=0.10). Sonuç: Her iki havayolu gereci de uygun hasta ve deneyimli uygulayıcılarla laparoskopik kolesistektomide güvenli bir şekilde kullanılabilir. Ancak her iki havayolu gerecini hem postoperatif bulantı ve kusma yönünden karşılaştıran hem de kesin sonuçlar veren çalışmalar gerekmektedir.

Keywords:

Laparoscopic cholecystectomy, supraglottic airway devices, laryngeal mask airway, proseal, supreme,

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