The LMA Supreme is superior to the LMA Classic because of its ease of insertion with low cuff pressure and high oropharyngeal leakage pressure.

ÖZETAmaç: Çalışmamızda; tiroid cerrahisi planlanan hastalarda anestezi indüksiyonu ve devamında MgSO 4 kullanılması-nın anestezik ajan gereksinimi, kas gevşetici tüketimi, peroperatif hemodinami, postoperatif derlenme ve postoperatif analjezi üzerine etkilerini araştırmayı amaçladık. Bulgular: Entübasyon sonrası ve intraoperatif 15. dk. ortalama arter basınçları, kalp atım hızı Grup K'da daha yüksek saptandı. İndüksiyonda gereken propofol miktarı ve idamedeki % Fi sevofluran, rokuronyum tüketimi Grup M'de daha azdı. T1 % 10 yanıtı ve T1 % 25 yanıt süreleri Grup M'de daha geç gerçekleşti. Ekstübasyon, verbal uyarılara yanıt, sözel yanıt, Aldrete Skoru 10 olma zamanı Grup M'de daha uzun bulundu. Grup M'de VAS değerleri 10. dk., 20. dk. ve 30. dk.'larda daha düşük bulundu ve ilk analjezik gereksinim zamanı daha uzun sürede gerçekleşti.Sonuç: Perioperatif MgSO 4 kullanılması; entübasyona hemodinamik yanıtı, anestezi indüksiyonu ve anestezi uygulamasının sürdürülmesinde anestezik madde gereksinimini azaltmakta, rokuronyumun etkisini potansiyalize etmekte ve postoperative ağrı kontrolüne olumlu etki göstermektedir.Anahtar kelimeler: Magnezyum sülfat, tiroid, rokuronyum SUMMARY The Usage of Magnesium Sulphate During Induction and Maintenance of General AnesthesiaAim: We aimed to investigate the effects of MgSO 4 used during induction and maintenance of general anesthesia on anesthetic drug requirement, consumption of muscle relaxants, preoperative hemodynamics, postoperative recovery, and postoperative analgesia in patients scheduled for thyroid surgery.Material and Methods: Fifty patients (ASA I-II) were randomly allocated into two groups; Group M received 30 mg kg -1 MgSO 4 15 minutes before induction followed by 15 mg kg -1 h -1 MgSO 4 infusion, and Group K 0.9 % NaCI. Anesthesia was induced with intravenous administration of 20 mg propofol, 1 µg fentanyl and 0.6 mg kg -1 rocuronium every 5 seconds keeping BIS at 60. 1 mg kg -1 i.v. for the maintenance of anesthesia sevoflurane was used so as to keep BIS between 50, and 60. Tramadol (1 mg kg -1 iv) was used for postoperative analgesia. Postoperative analgesia level was recorded at 10., 20., 30. min and 1., 2., 3., 6. h using Visual Analogue Scale (VAS), and 75 mg diclofenac sodium iv. was administered to patients with a score of 5 or higher. Kolmogorov-Smirnov, Student's t, Man-Whitney U and Chi-square test were used for statistical analysis.Results: Postintubation and intraoperative 15. minute MAP and HR values were significantly higher in Group K patients. Propofol requirement at induction, and FI % for sevoflurane, at maintenance and total rocuronium consumption were significantly lower in Group M. T1 10 % and T1 25 % response times were delayed in Group M. Extubation time, response to verbal stimuli, verbal response time, and time to reach a score of 10 modified Aldrete score of 10 were found to be prolonged in Group M. In Group M, 10., 20., 30. min VAS scores were lower, and time to the first requirement for an analgesic was also delayed.Conclusion: Peroperativ...

GirişE ndotrekeal entübasyon, 1981 yılına kadar cerrahi girişimlerde hava yolu açıklığının güvenli bir şekilde sağlanmasının tek yolu olarak görülmekteydi. Fakat Brain tarafından üretilen ilk supraglotik hava yolu aracı olan, klasik laringeal maske (LMA) bu durumu değiştirmiştir (1). Laringeal maske kullanımı yıllar içerinde hızla yaygınlaşmış ve anestezi uygulamasında birçok avantaj sağlamıştır (2, 3).Uzun yıllardır anestezi pratiğinde başarıyla ve güvenle kullanılan LMA, her başarılı yeni üretilen tıbbi alette olduğu gibi hızla geliştirilmiş ve bir çok farklı modelleri üretilmiştir. Yeni supraglotik hava yolu (SGA) aracı geliştirmesinde, daha kolay uygulanabilme, hızlı yerleştirilme, aspirasyon riskinin azaltılması, yüksek basınçlarda da ventilasyonu sağlayabilme, azalmış hemodinamik cevap ve yan etki insidansının azaltılması, ana hedefler olmuştur (4). Yeni üretilen SGA aracı modelleri, klasik LMA'ya oranla, daha geniş kullanım alanı bul-Objective: Laryngeal mask airways (LMA) are used successfully and safely in anaesthetic practice, and have undergone rapid development, with many different models having been produced. We compare Proseal LMA (PLMA), Supreme LMA (SLMA) and Cobra Perilaryngeal Airway (CPLA) in terms of placement characteristics, leak pressure, haemodynamic data and post-operative side effects.Methods: A total of 150 adult patients scheduled for varices or one-sided inguinal hernia surgery were included in the study. Depending on the airway device used in surgery, the patients were divided into three different groups: PLMA Group (Group P), SLMA Group (Group S) and CPLA Group (Group P). Standard anaesthesia induction and maintenance was applied to all groups. In each one of the three groups, success in supraglottic airway (SGA) device placement, time needed for placement, placement complications, intra-operative haemodynamic data, percentage of air leak, peak pressure (Ppeak), mean pressure (Pmean), leak pressure values and side effects were recorded. Results:The time to successfull placement for PLMA, SLMA and CPLA was 20.4±4.2 sec, 17.6±4.3 sec and 19.6±3.4 sec respectively. The placement time for SLMA was significantly shorter. Leak pressure was 31.2±2.4 cmH 2 O for Group P, 27.5±4.4 cmH 2 O for Group S and 30.7±2.2 cmH 2 O for Group C. The leak pressure values measured for Group P and Group C were higher than those in Group S. Side effects were observed more frequently in Group C during the post-operative period.Conclusion: All LMA devices provide sufficient airway clearance. With regards to the brevity of placement time, Supreme LMA was more efficient. However, as they had a higher leak pressure, we recommend CPLA and PLMA for surgeries that require high pressure ventilation. In addition, it is important to note that post-operative complications were observed more frequently with the CPLA.