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Deksmedetomidinin çocuklarda laringeal maske airway ve kobra perilarengeal airway kullanımına etkileri

Year 2019, Volume: 44 Issue: 4, 1418 - 1424, 29.12.2019

Abstract

Amaç: Bu çalışmanın amacı çocuklarda deksmedetomidinin laringeal maske hava yolu ve kobra perilarengeal hava yolu kullanımına etkilerini değerlendirmektir.

Gereç ve Yöntem: LMA veya CobraPLA ile elektif inguinal bölge cerrahisi sırasında tek başına sevofluran ve sevofluran + deksmedetomidin (yükleme dozu 1 µg/kg + infüzyon 0.5 µg/kg/sa) alan 112 çocuğun tıbbi kayıtları retrospektif olarak incelendi: Grup LMA, Grup CobraPLA, Grup Dex + LMA ve Grup Dex + CobraPLA. Hastaların demografik verileri, hemodinamik parametreleri, etkin bir havayolu elde etmek için deneme sayısı ve zamanı, end-tidal sevofluran (ETSevo) konsantrasyonu, plato basıncı (P plato), pik inspirasyon basıncı (PIP), end-tidal karbondioksit (ETCO2) değerleri ve komplikasyonlar kaydedildi.

Bulgular: Demografik ve anestezik veriler, hemodinamik parametreler ve komplikasyonlar gruplar arasında benzerdi. Deneme sayısı, yerleştirme zamanı, P plato ve PIP sayısı, LMA grubunda diğer gruplara göre istatistiksel olarak daha yüksekti. ETSevo konsantrasyonları Dex + CobraPLA grubunda LMA ve CobraPLA gruplarına göre daha düşüktü. ETCO2 ölçümleri CobraPLA ve Dex + CobraPLA gruplarında diğer gruplara göre daha yüksekti.

Sonuç: Bu çalışmada, supraglottik havayolu cihazları kullanılan çocuklarda deksmedetomidinin havayolu basınçlarını ve ETSevo konsantrasyonlarını yan etki olmaksızın azalttığı saptanmıştır.


References

  • 1. Nam SB HD, Chang CH, Lee JS. A randomised, crossover comparison between the CobraPLA and the LMA Classic in paralysed patients. Anaesthesia. 2007;62(12):1285-8.2. Biedler A, Wrobel M, Schneider S, Soltesz S, Ziegeler S, Grundmann U. Randomized evaluation of the size 2 laryngeal tube and classical laryngeal mask airway in different head and neck positions in children under positive pressure ventilation. J Anesth. 2013;27(5):657-62.3. Cox RG, Lardner DR. Supraglottic airways in children: past lessons, future directions. Can J Anaesth. 2009;56(9):636-42.4. Lerman J. Inhalation agents in pediatric anaesthesia - an update. Curr Opin Anaesthesiol. 2007;20(3):221-6.5. Savla JR, Ghai B, Bansal D, Wig J. Effect of intranasal dexmedetomidine or oral midazolam premedication on sevoflurane EC50 for successful laryngeal mask airway placement in children: a randomized, double-blind, placebo-controlled trial. Paediatr Anaesth. 2014;24(4):433-9.6. He L, Wang X, Zheng S. Effects of dexmedetomidine on sevoflurane requirement for 50% excellent tracheal intubation in children: a randomized, double-blind comparison. Paediatr Anaesth. 2014;24(9):987-93.7. Guler G, Akin A, Tosun Z, Eskitascoglu E, Mizrak A, Boyaci A. Single-dose dexmedetomidine attenuates airway and circulatory reflexes during extubation. Acta Anaesthesiol Scand. 2005;49(8):1088-91.8. Mikami M, Zhang Y, Kim B, Worgall TS, Groeben H, Emala CW. Dexmedetomidine's inhibitory effects on acetylcholine release from cholinergic nerves in guinea pig trachea: a mechanism that accounts for its clinical benefit during airway irritation. BMC Anesthesiol. 2017;17(1):52.9. Yao Y, Qian B, Lin Y, Wu W, Ye H, Chen Y. Intranasal dexmedetomidine premedication reduces minimum alveolar concentration of sevoflurane for laryngeal mask airway insertion and emergence delirium in children: a prospective, randomized, double-blind, placebo-controlled trial. Paediatr Anaesth. 2015;25(5):492-8.10. Tobias JD. Dexmedetomidine: applications in pediatric critical care and pediatric anesthesiology. Pediatr Crit Care Med. 2007;8(2):115-31.11. CobraPLA brochure. Available from: [Available from: www.nghiemviet.vn/Upload/Documents/6133H%20CobraPLA%20Brochure.pdf.12. LMA ClassicTM brochure. Available from: [Available from: http://www.lmaco.com/sites/default/files/31817-LMA-Classic-A4Data-0214-LORES-fnl.pdf.13. Xu R, Zhu Y, Fan Q, Shen X, Li WX. Comparison Between the Cobra Perilaryngeal Airway and Laryngeal Mask Airways Under General Anesthesia: A Systematic Review and Meta-analysis. Anesth Analg. 2017;125(3):958-66.14. Lawrence CJ, De Lange S. Effects of a single pre-operative dexmedetomidine dose on isoflurane requirements and peri-operative haemodynamic stability. Anaesthesia. 1997;52(8):736-44.15. Deutsch E, Tobias JD. Hemodynamic and respiratory changes following dexmedetomidine administration during general anesthesia: sevoflurane vs desflurane. Paediatr Anaesth. 2007;17(5):438-44.16. Aho M, Erkola O, Kallio A, Scheinin H, Korttila K. Dexmedetomidine infusion for maintenance of anesthesia in patients undergoing abdominal hysterectomy. Anesth Analg. 1992;75(6):940-6.17. Kim NY, Kim SY, Yoon HJ, Kil HK. Effect of dexmedetomidine on sevoflurane requirements and emergence agitation in children undergoing ambulatory surgery. Yonsei Med J. 2014;55(1):209-15.18. Patel A, Davidson M, Tran MC, Quraishi H, Schoenberg C, Sant M, et al. Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy. Anesth Analg. 2010;111(4):1004-10.19. Lee SH, Kim N, Lee CY, Ban MG, Oh YJ. Effects of dexmedetomidine on oxygenation and lung mechanics in patients with moderate chronic obstructive pulmonary disease undergoing lung cancer surgery: A randomised double-blinded trial. Eur J Anaesthesiol. 2016;33(4):275-82.

Effects of dexmedetomidine on the use of laryngeal mask airway and the cobra perilaryngeal airway in children

Year 2019, Volume: 44 Issue: 4, 1418 - 1424, 29.12.2019

Abstract

Purpose: The aim of this study was to evaluate the effects of dexmedetomidine on the use of laryngeal mask airway and the cobra perilaryngeal airway in children.

Materials and Methods: The medical records of 112 children who received sevoflurane alone and sevoflurane plus dexmedetomidine (loading dose 1 µg/kg + infusion 0.5 µg/kg/h) during elective inguinal region surgery with LMA or CobraPLA were retrospectively reviewed: Group LMA, Group CobraPLA, Group Dex+LMA and Group Dex+CobraPLA. Patients’ demographic data, hemodynamic parameters, the number of trials and time to achieve an effective airway, the end-tidal sevoflurane (ETSevo) concentration, plateau pressure (P plateau), peak inspiratory pressure (PIP), end-tidal carbondioxide (ETCO2) values, and complications were noted.

Results: Demographic and anesthetic data, hemodynamic parameters, and complications were similar between the groups. The number of attempts, the time for insertions, P plateau, and PIP were statistically higher in the LMA group compared to other groups. ETSevo concentrations were lower in the Dex+CobraPLA group compared to LMA and CobraPLA group. The ETCO2 measurements were higher in the CobraPLA and Dex+CobraPLA groups compared to other groups. 

Conclusion: Dexmedetomidine reduced airway pressures and ETSevo concentrations without side effects in the children with SADs.


References

  • 1. Nam SB HD, Chang CH, Lee JS. A randomised, crossover comparison between the CobraPLA and the LMA Classic in paralysed patients. Anaesthesia. 2007;62(12):1285-8.2. Biedler A, Wrobel M, Schneider S, Soltesz S, Ziegeler S, Grundmann U. Randomized evaluation of the size 2 laryngeal tube and classical laryngeal mask airway in different head and neck positions in children under positive pressure ventilation. J Anesth. 2013;27(5):657-62.3. Cox RG, Lardner DR. Supraglottic airways in children: past lessons, future directions. Can J Anaesth. 2009;56(9):636-42.4. Lerman J. Inhalation agents in pediatric anaesthesia - an update. Curr Opin Anaesthesiol. 2007;20(3):221-6.5. Savla JR, Ghai B, Bansal D, Wig J. Effect of intranasal dexmedetomidine or oral midazolam premedication on sevoflurane EC50 for successful laryngeal mask airway placement in children: a randomized, double-blind, placebo-controlled trial. Paediatr Anaesth. 2014;24(4):433-9.6. He L, Wang X, Zheng S. Effects of dexmedetomidine on sevoflurane requirement for 50% excellent tracheal intubation in children: a randomized, double-blind comparison. Paediatr Anaesth. 2014;24(9):987-93.7. Guler G, Akin A, Tosun Z, Eskitascoglu E, Mizrak A, Boyaci A. Single-dose dexmedetomidine attenuates airway and circulatory reflexes during extubation. Acta Anaesthesiol Scand. 2005;49(8):1088-91.8. Mikami M, Zhang Y, Kim B, Worgall TS, Groeben H, Emala CW. Dexmedetomidine's inhibitory effects on acetylcholine release from cholinergic nerves in guinea pig trachea: a mechanism that accounts for its clinical benefit during airway irritation. BMC Anesthesiol. 2017;17(1):52.9. Yao Y, Qian B, Lin Y, Wu W, Ye H, Chen Y. Intranasal dexmedetomidine premedication reduces minimum alveolar concentration of sevoflurane for laryngeal mask airway insertion and emergence delirium in children: a prospective, randomized, double-blind, placebo-controlled trial. Paediatr Anaesth. 2015;25(5):492-8.10. Tobias JD. Dexmedetomidine: applications in pediatric critical care and pediatric anesthesiology. Pediatr Crit Care Med. 2007;8(2):115-31.11. CobraPLA brochure. Available from: [Available from: www.nghiemviet.vn/Upload/Documents/6133H%20CobraPLA%20Brochure.pdf.12. LMA ClassicTM brochure. Available from: [Available from: http://www.lmaco.com/sites/default/files/31817-LMA-Classic-A4Data-0214-LORES-fnl.pdf.13. Xu R, Zhu Y, Fan Q, Shen X, Li WX. Comparison Between the Cobra Perilaryngeal Airway and Laryngeal Mask Airways Under General Anesthesia: A Systematic Review and Meta-analysis. Anesth Analg. 2017;125(3):958-66.14. Lawrence CJ, De Lange S. Effects of a single pre-operative dexmedetomidine dose on isoflurane requirements and peri-operative haemodynamic stability. Anaesthesia. 1997;52(8):736-44.15. Deutsch E, Tobias JD. Hemodynamic and respiratory changes following dexmedetomidine administration during general anesthesia: sevoflurane vs desflurane. Paediatr Anaesth. 2007;17(5):438-44.16. Aho M, Erkola O, Kallio A, Scheinin H, Korttila K. Dexmedetomidine infusion for maintenance of anesthesia in patients undergoing abdominal hysterectomy. Anesth Analg. 1992;75(6):940-6.17. Kim NY, Kim SY, Yoon HJ, Kil HK. Effect of dexmedetomidine on sevoflurane requirements and emergence agitation in children undergoing ambulatory surgery. Yonsei Med J. 2014;55(1):209-15.18. Patel A, Davidson M, Tran MC, Quraishi H, Schoenberg C, Sant M, et al. Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy. Anesth Analg. 2010;111(4):1004-10.19. Lee SH, Kim N, Lee CY, Ban MG, Oh YJ. Effects of dexmedetomidine on oxygenation and lung mechanics in patients with moderate chronic obstructive pulmonary disease undergoing lung cancer surgery: A randomised double-blinded trial. Eur J Anaesthesiol. 2016;33(4):275-82.
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Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research
Authors

Zehra Hatipoglu 0000-0001-7581-5966

Beyza Tekin This is me 0000-0002-7035-0167

Mediha Türktan 0000-0002-7378-6265

Ersel Güleç 0000-0002-8415-8571

Dilek Özcengiz 0000-0002-2598-0127

Publication Date December 29, 2019
Acceptance Date May 25, 2019
Published in Issue Year 2019 Volume: 44 Issue: 4

Cite

MLA Hatipoglu, Zehra et al. “Effects of Dexmedetomidine on the Use of Laryngeal Mask Airway and the Cobra Perilaryngeal Airway in Children”. Cukurova Medical Journal, vol. 44, no. 4, 2019, pp. 1418-24.