Akademik Veri Yönetim Sistemi
ACTA ANAESTHESIOLOGICA SCANDINAVICA, cilt.55, sa.5, ss.530-534, 2011 (SCI-Expanded)
Background This study evaluates the influence of sniffing position combined with mouth opening on the effectiveness of facemask ventilation in paralyzed pediatric patients undergoing adenotonsillectomy during sevoflurane-N2O anesthesia. Methods After Institutional Ethics Committee approval, 40 children 5-11 years of age who were scheduled for an elective adenotonsillectomy operation were enrolled in this prospective randomized study. After routine monitoring and pre-oxygenation, anesthesia was induced with sevoflurane 8% in a mixture of 50% N2O-O-2. Three minutes after the administration of vecuronium, the sequence of the positions was randomized. Three positions were applied during facemask ventilation: Position CN (closed mouth - neutral head and neck position), position CS (closed mouth-sniffing position) and position OS (opened mouth-sniffing position). Volume-controlled ventilation was started. Peak inspiratory pressure (PIP), tidal volume (V-T), expired tidal volume (V-Texp) and end-tidal CO2 pressure were recorded. The percent of leakage was calculated. The primary endpoint of this study was the expired tidal volume (V-Texp). Results There was a statistically significant difference among the three positions for V-Texp and PIP values. The OS resulted in higher V-Texp values when compared with CN (P=0.022). The OS was significantly better than the other two positions, resulting in lower PIP values (P < 0.001 and P=0.004, for CN and CS, respectively). The OS also resulted in less leakage during facemask ventilation when compared with CN and CS. Conclusions Sniffing position combined with mouth opening improves V-Texp and PIP values during facemask ventilation during sevoflurane-N2O anesthesia in paralyzed pediatric patients with adenotonsillar hypertrophy.