Turkiye Klinikleri Journal of Anesthesiology Reanimation

.: ORIGINAL RESEARCH
Comparison of the LMA Protector and the Baska Mask in Retrograde Ureteroscopic Surgery: A Prospective Randomized Clinical Study
LMA Protector ve Baska Maskın Retrograd Üreteroskopik Cerrahide Karşılaştırılması: Prospektif Randomize Klinik Çalışma
Zehra İpek ARSLANa, Huri YEŞİLDALa, Enes Malik AKDAŞb, Merve YAZICI KARAc, Sibel BALCId
aDepartment of Anesthesiology and Reanimation, Kocaeli University Medical Faculty, Kocaeli, Türkiye
bDepartment of Urogenital Surgery, Kocaeli University Medical Faculty, Kocaeli, Türkiye
cClinic of Anesthesiology and Reanimation, Kocaeli Research and Education Hospital, Kocaeli, Türkiye
dDepartment of Biostatistics and Medical Informatics, Kocaeli University Medical Faculty, Kocaeli, Türkiye
Turkiye Klinikleri J Anest Reanim. 2023;21(1):8-16
doi: 10.5336/anesthe.2022-94932
Article Language: EN
Full Text
ABSTRACT
 Objective: The Baska and the Protector Laryngeal masks are single-use second-generation supraglottic airway devices with a dual gastric channel. Material and Methods: 64 American Society of Anesthesiologists physical status 1-2 patients between the ages of 18-70 undergoing retrograde ureteroscopic surgery enrolled in this prospective randomized study. Results: Demographic airway variables and airway characteristics were similar between the groups. Insertion time was shorter in the Baska mask group [14 (11-20) versus 20 (13-27) seconds, p=0.035]. The need for optimization maneuvers during insertion was higher for the Baska mask group (p=0.009). The laryngeal mask airway (LMA) insertion was easier in the LMA Protector group (p=0.023). The first insertion success rate was 75% for the LMA Protector and 84% in the Baska mask. The total success rate of both devices was 91%. Nasogastric tube insertion was faster in the Baska mask group [14 (12-15) versus 17 (13-25) seconds; p=0.003]. Fiberoptic views were similar between the groups. Minute volume after insertion of the device was higher in the LMA Protector group [8 (6.5-10) L/min versus 6 (5-7) L/min; p<0.001]. Expiratory tidal volume was higher in the LMA Protector group after insertion of the device, 15 minutes, 30 minutes, and 45 minutes after insertion (p<0.001, p=0.032, p=0.001, p=0.027 respectively). The end-tidal sevoflurane concentration (ETsevo) 30 minutes after device insertion was higher in the Baska mask group (1.49±0.38 vs 1.75±0.36; p=0.014). Conclusion: The LMA Protector is superior to the Baska mask in providing higher tidal volumes and decreased need for optimization maneuvers in retrograde ureteroscopic surgery.

Keywords: Adult; laryngeal masks; mechanical ventilation; ureteroscopy
ÖZET
 Amaç: Baska ve Proseal Laringeal maskeleri, 2'li gastrit kanala sahip olan tek kullanımlık 2. jenerasyon supraglottik havayolu araçlarıdır. Gereç ve Yöntemler: Retrograd üreteroskopik cerrahiye alınacak, Amerikan Anestezistler Derneği 1-2, 18-70 yaş arası 64 hasta prospektif randomize çalışmaya dâhil edildi. Bulgular: Demografik verileri ve havayolu karakteristikleri gruplar arasında benzerdi. Baska mask grubunun yerleştirme zamanı kısaydı [14'e (11-20) kıyasla 20 (13-27) saniye, p=0,035]. Yerleştirme sırasında ihtiyaç duyulan optimizasyon manevraları Baska mask grubunda fazlaydı (p=0,009). Laringeal maske havayolu [laryngeal mask airway (LMA)] yerleştirmesi, LMA Protector grubunda daha kolaydı (p=0,023). İlk deneme yerleştirme başarısı LMA Protector için %75 iken, Baska mask için %84 idi. Toplam başarı oranları ise 2 cihazda da %91 idi. Nazogastrik tüp yerleştirmesi Baska mask grubunda hızlıydı [14 (12-15) kıyasla 17 (13-25) saniye; p=0,003]. Gruplar arasında fiberoptik görüntüler benzerdi. Yerleştirme sonrası dakika hacimleri LMA Protector grubunda daha fazlaydı [8 (6,5-10) L/dk'ya kıyasla 6 (5-7) L/dk; p<0,001]. Ekspiratuar tidal hacim, LMA Protector grubunda yerleştirme sonrası, yerleştirmeden 15 dk, 30 dk ve 45 dk sonra fazlaydı (p<0,001, p=0,032, p=0,001, p=0,027 respectively). End-tidal sevofluran konsantrasyonu (ETsevo) cihazın yerleştirilmesinden 30 dk sonra Baska mask grubunda yüksekti (1,49±0,38'e kıyasla 1,75±0,36; p=0,014). Sonuç: LMA Protector, yüksek tidal hacim sağlaması, azalmış optimizasyon manevrası gereksinimi ile retrograd üreteroskopide Baska maska üstündür.

Anahtar Kelimeler: Erişkin; laringeal maske havayolu; mekanik ventilasyon; üreteroskopi
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