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Çocuklarda ProSeal Laringeal Maske: 428 Olgunun Geriye Dönük İncelenmesi

ProSeal Laringeal Mask in Children: Retrospective Study of 428 Cases

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Abstract (2. Language): 
Aim: ProSeal LMA (LMA) was developed on the basis of the classic LMA is a supraglottic airway device. In this study, anesthesia records of 428 pediatric patients who PLMA were inserted after induction of general anesthesia in pediatric surgery between May 2009 and June 2011 were reviewed retrospectively. Material-Methods: Demographic characteristics, ASA score, type of surgery and anesthesia time, the premeditation, induction agents, positions of patients, PLMA placement technique, the number of attempts, the practitioners' experience of anesthesia and complications encountered were recorded retrospectively. Results: Anesthesia was induced intravenously or inhalationally in 355 and 73 patients, respectively. PLMA was placed at the first trial to 411 patients and at the second trial to 14 patients. 342 patients who PLMA were inserted underwent to the operation in the supine position, 86 patients had the operation in lithotomy position. PLMA was placed with digital technique to 355 patients, introducer was used in 73 patients. After PLMA was placed, in 4 patients laryngospasm, in 3 patients bronchospasm, in one patient gastric distension, in two patients hiccup developed. After placement of PLMA two patients vomited. After removal of PLMA laryngospasm developed in three patients, blood transmission at PLMA has been found in 2 patients. Conclusion: In children, PLMA with allowing high leak pressures than the classic LMA and separating glottis to esophagus, high placement success and low complication rate is an effective airway device.
Abstract (Original Language): 
Amaç: ProSeal Laringeal Maske (PLMA) klasik LMA temelinde geliştirilen supraglottik bir hava yolu aracıdır. Bu çalışmada Mayıs 2009 ile Haziran 2011 tarihleri arasında çocuk cerrahisi ameliyatlarında genel anestezi indüksiyonu sonrası PLMA uygulanan 428 pediyatrik hasta, anestezi kayıtları gözden geçirilerek geriye dönük olarak değerlendirildi. Gereç ve Yöntem: Çalışmaya alınan hastaların demografik özellikleri, ASA skorları, cerrahi girişim türü ve anestezi süresi, uygulanan premedikasyon, indüksiyon ajanları, hastaların pozisyonları, yerleştirilen PLMA numarası ve hangi yöntemle yerleştirildiği, girişim sayısı, uygulayıcıların anestezi tecrübeleri ve karşılaşılan komplikasyonlar kaydedildi. Bulgular: Anestezi indüksiyonu 355 hastada intravenöz, 73 hastada inhalasyon ajanlarıyla sağlanmıştır. Hastaların 411’ine birinci denemede, 14’üne ikinci denemede PLMA yerleştirilmiştir. PLMA uygulanan hastaların 342’si supin pozisyonda, 86’sı litotomi pozisyonunda operasyon geçirmiştir. 355 hastada dijital teknik ile PLMA takılırken, 73 hastada introduser kullanılmıştır. PLMA yerleştirildikten sonra 4 hastada laringospazm, üç hastada bronkospazm, bir hastada mide distansiyonu, iki hastada hıçkırık gelişmiştir. İki hasta PLMA yerleştirildikten sonra kusmuştur. PLMA çıkarıldıktan sonra üç hastada laringospazm gelişmiş, iki hastada PLMA’da kan bulaşı tesbit edilmiştir. Sonuç: Çocuklarda, PLMA başarılı yerleştirme oranı yüksek, komplikasyon oranı düşük, klasik LMA’ya göre daha yüksek kaçak basınçlarına izin veren, özefagusu glottisden ayıran etkili bir havayolu aracıdır.
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