Zekine BEGEÇ, Mahmut DURMUŞ, Feray ERDİL, Erdoğan ÖZTÜRK, Aytaç YÜCEL, M. Özcan ERSOY

Çocuklarda Laringeal Maskenin Çıkarılması İçin Gerekli Sevofluran Minimum Alveoler Konsantrasyonuna Kaudal Anestezinin Etkisi

Amaç: Kaudal anestezi uygulanan çocuklarda laringeal maske (LMA) çıkarılması için gerekli sevofluran minimum alveolar konsantrasyonunu (MAK) değerlendiren bir çalışma bulunmamaktadır. Çalışmanın amacı kaudal anestezi uygulanmış çocuklarda LMA çıkarılması için gerekli sevofluran MAK'ını belirlemektir. Materyal ve Metod: Genel anestezi ile ürolojik cerrahiye giden (<2 saat) 56 çocuk çalışmaya alındı. Sevofluran indüksiyonundan sonra LMA yerleştirilen çocuklar kaudal anestezi yapılan ve yapılmayan grup olarak ayrıldı. Cerrahi işlemin sonunda LMA; grupları bilmeyen bir anestezist tarafından, end-tidal sevofluran konsantrasyonu önceden belirlenen % 0.2'lik konsantrasyonlarla azaltılarak çıkartıldı. LMA çıkarılması sırasında veya çıkarıldıktan sonra 1 dakika içinde, öksürük, diş sıkma, amaçlı hareket, nefes tutma veya laringospazm eşlik etmiyorsa LMA çıkarılması başarılı olarak kabul edildi. Bulgular: Çocuklarda LMA çıkarılması için gerekli sevofluran MAK'ı kaudal anestezi uygulanan grupta %1.60, kaudal anestezi uygulanmayan grupta %1.72 idi. Sonuç: İki ay-8 yaş arası çocuklarda kaudal anestezi; LMA çıkarılması için gerekli sevofluran MAK'ını azaltmadı. Kaudal bloğun infant ve çocuklarda LMA çıkarılması için gerekli sevofluran MAK'ına etkisini araştıran ileri çalışmalara ihtiyaç olduğu kanaatine varıldı. Anahtar kelimeler: Sevofluran, Laringeal Maske, Kaudal Anestezi

Anahtar Kelimeler:

Sevofluran, Laringeal Maske, Kaudal Anestezi

Minimum Alveolar Concentration of Sevoflurane for Laryngeal Mask Airway Removal in Children; the Effect of Caudal Anesthesia

Objective: There has been no study evaluating sevoflurane minimum alveolar concentration for the laryngeal mask airway (LMA) removal (MAC-LMA removal) in children whom caudal anesthesia was performed. The aim of this study is to determine the MAC-LMA removal of sevoflurane in children caudal anesthesia was performed. Materials and Methods: Fifty-six children undergoing elective urologic surgery for <2 h under general anesthesia were studied. After sevoflurane induction, children were randomized to receive LMA insertion with or without caudal anesthesia. The LMA was removed at the end of surgery when the end-tidal sevoflurane concentration had reduced to a predetermined level with 0.2% as a step size by an anesthesiologist blinded to group allocation. When LMA removal was accomplished without coughing, teeth clenching, gross purposeful movement, breath holding or laryngospasm, during or within 1 min after removal, it was considered successful. Results: The MAC-LMA removal of sevoflurane was 1.60% in the group with caudal anesthesia and 1.72% in the group without caudal anesthesia. Conclusion: Caudal anesthesia did not reduce the MAC-LMA removal of sevoflurane in children aged 2 mo and 8 yr. Further studies are necessary to establish whether caudal block effect the removal of LMA in infant and children during sevoflurane anesthesia. Key words: Sevoflurane, Laryngeal Mask Airway, Caudal Anesthesia

Keywords:

Sevoflurane, Laryngeal Mask Airway, Caudal Anesthesia,

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Corresponding Author: Zekine BEGEÇ, MD.
Inonu University, School of Medicine,
MALATYA-TURKEY
Phone: +905334672937 Fax: +904223410036
E-mail: zozpolat@inonu.edu.tr