Tek Kullanımlık Süprem Laringeal Maskesi ile Çok Kullanımlık Proseal Laringeal Maskesinin Acil Apendektomide Karşılaştırılması

Abstract

Objective: Both ProSeal and Supreme laryngeal mask airways increase protection by separating the respiratory and gastro-intestinal tracts during general anaesthesia. We planned to compare the efficacy of these devices in 6 hour fasted adult patients undergoing emergency appendicectomy. Material and Methods: Seventy patients aged from 18 to 64 years, ASA physical status I-II were enrolled in this study. After standard monitoring and anesthesia induction, one of these airway devices was inserted and ease of insertion, oropharyngeal leak pressures during the procedure 10 minutes intervals, ease of nasogastric tube insertion, ventilation parameters, need of rocuronium supplementation, hemodynamic parameters, minor complications, preoperative and postoperative cuff volumes were recorded. Results: Demographic characteristics of patients were similar in both groups. There were no differences in first insertion success rates, ease of nasogastric tube insertion, ventilation parameters, rocuronium supplementation and postoperative minor complications between groups. Both ProSeal and Supreme laryngeal mask airways provided oropharyngeal leak pressures of more than 26 cmH2O during the procedure. Both ProSeal laryngeal mask airway and Supreme laryngeal mask airways were statistically significantly decreased the heart rate after insertion (p=0.001 vs p=0.02, respectively). Additionally both airway devices decreased the mean arterial pressure significantly after insertion when compared to the postinduction values (p=0.000). When cuff volumes at the beginning and at the end of the surgery were compared with in-groups; it was seen that postoperative cuff volumes were increased in each group (p<0.001). Conclusion: Both Supreme laryngeal mask airway and ProSeal laryngeal mask airway can be a safely alternative to endotracheal tube because of their ability to facilitate high pressure ventilation in 6 hours fasted patients during emergency appendectomy.