.: ORİJİNAL ARAŞTIRMA
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
Turkiye Klinikleri J Anest Reanim. 2023;21(1):8-16
doi: 10.5336/anesthe.2022-94932
Makale Dili: EN
Tam Metin
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
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
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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