Septorinoplasti operasyonlarında ProSeal laryngeal maske ve entübasyon tüpünün karşılaştırılması

Year 2021, Volume: 46 Issue: 4, 1468 - 1477, 30.12.2021

Dilek Yeniay , Bahanur Çekiç

https://doi.org/10.17826/cumj.978120

Abstract

Amaç: Bu çalışmada amacımız elektif septorinoplasti operasyonunda ProSeal laryngeal maske havayolu (PLMA) ve endotrakeal tüp (ETT) kullanmak ve uygulama sırasında ortaya çıkan hemodinamik farklılıkları ve postoperati ve komplikasyonları karşılaştırmaktır.
Gereç ve Yöntem: Prospektif planlı çalışmada ASA I-II ve 18-35 yaş arası 60 hasta rastgele iki gruba ayrıldı (n=30,n=30). Standart anestezi tekniğinin ardından Grup E’ye ETT, Grup P’ye PLMA yerleştirildi. Hastaların demografik özellikleri, doğru yerleştirme girişimleri, hemodinamik değişiklikler, ameliyat sonrası bulantı, kusma, boğaz ağrısı, ses kısıklığı, yutma güçlüğü ve cerrahi memnuniyet değerlendirildi.
Bulgular: Anestezi indüksiyonu sonrası 1. dk, havayolu yerleşimi sonrası 1., 2., 3., 4., 5. ve 10.dk ve ekstübasyon sonrası 3.dk kalp hızı Grup E'de Grup P'ye göre daha yüksekti. Postoperatif yutma güçlüğü Grup E'de Grup P'ye göre daha yüksekti. Cihazların yerleştirme oranları benzerdi. Grup E'de Grup P'ye göre cerrahi memnuniyet daha yüksekti. Operasyon sırasında her iki grupta da yeterli tidal volüm sağlandı.
Sonuç: Günübirlik yapılan septorinoplasti operasyonlarında havayolu yönetiminde PLMA kullanımının ETT kullanımına göre daha az hemodinamik yanıt oluşturduğunu, daha az havayolu komplikasyonu görüldüğünü ve esnekliği sayesinde cerrahi alana müdahale etmediğini saptadık. Havayolu cihazlarının yerleştirilmesi deneyimli hekimler tarafından yapıldığında PLMA, ETT'ye alternatif olabilir.

Keywords

Endotrakeal entübasyon, laryngeal maske havayolu, rinoplasti

Comparison of the ProSeal laryngeal mask airway and endotracheal tube in septorhinoplasty surgery

Abstract

Purpose: The aim of this study is to use ProSeal laryngeal mask airway (PLMA) and endotracheal tube (ETT) in elective septorhinoplasty operation and to compare the hemodynamic differences and postoperative complications during the application.
Materials and Methods: In the prospective planned study, ASA I-II and 60 patients aged 18-35 were randomly allocated into two groups (n = 30, n = 30). After the standard anesthesia technique, Group E was placed ETT, Group P PLMA. Patients’ demographic characteristics, number of attempts for correct insertion, hemodynamic changes, postoperative nausea, vomiting, sore throat, hoarseness, dysphagia and surgical satisfaction evaluated.
Results: Heart rate was higher in Group E than in Group P at the 1st min after anesthesia induction, at the 1st, 2nd, 3rd, 4th, 5th, and 10th min after airway insertion, and at the 3rd min after extubation. Difficulty in swallowing at postoperative was higher in Group E than in Group P. Insertion rates of the devices, were similar. Surgical satisfaction was higher in Group E than in Group P. Adequate tidal volume was provided in both groups during the operation.
Conclusion: The use of PLMA in airway management in outpatient septorhinoplasty operations creates less hemodynamic response compared to the use of ETT, less airway complications are seen and thanks to its flexibility, it does not interfere with the surgical area. PLMA may be an alternative to ETT when the insertion of the airway devices is performed by experienced physicians.

Keywords

Endotracheal intubation, laryngeal mask airway, rhinoplasty

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