Under elective conditions, estimated 172 patients between 18 and 65 years of age who will
receive general anesthesia and ventilation with laryngeal mask airways (LMA) and the
duration of anesthesia will last more than 1 hour and less than 2 hours will be included
in the study. The study will be designed as a prospective, randomized, controlled study.
The 172 patients who will be admitted for elective surgery will be divided into two
groups as Group L and Group R by computer-assisted randomization method. Patients in
Group L will be ventilated with a classical laryngeal mask airways (cLMA) stored at 10 °C
to 12 °C (low temperatures), while patients in Group R will be ventilated with a
classical laryngeal mask airways (cLMA) stored at 22 °C to 25 °C (room temperatures).
Patients will be routinely evaluated preoperatively and written informed consent will be
taken. Patients' age, gender, weight, height, BMI (body mass index), comorbidities,
regular medications, type of surgery, ASA (American Society of Anesthesiologists)
physical status and mallampati score will be recorded in the preoperative waiting area.
When patients are admitted to the operating room, non-invasive arterial blood pressure
monitoring, 3 or 5-channel ECG and pulse oximetry monitoring will be performed in the
standard working order of the anesthesia clinic. Hemodynamic parameters; heart rate
(HR)(beats/minute), systolic arterial blood pressure (SBP)(mmHg), diastolic arterial
blood pressure (DBP)(mmHg), mean arterial blood pressure (MAP)(mmHg) and peripheral
oxygen saturation (SpO2) will be recorded at 0, 5, 10, 15, 30, 60, 90, and 120 minutes.
After preoxygenation (100% oxygen with balloon and mask for 3 minutes), anesthesia
induction will be performed with midazolam 0.02 mg/kg, fentanyl 2 mcg/kg, lidocaine 1
mg/kg and propofol 2mg/kg in both groups. 90 seconds after induction, patients in Group L
will be ventilated with a classical laryngeal mask airways (cLMA) stored at 10 °C to 12
°C (low temperatures), while patients in Group R will be ventilated with a classical
laryngeal mask airways (cLMA) stored at 22 °C to 25 °C (room temperatures). In both
groups, The cLMA will be inserted by an anesthesiologist who has at least 3 years of
experience. No lubricant material will be applied to the cLMA. The cLMA size of both
groups will be decided according to the weight of the patients. For cLMA, LMAs will be
applied as NO 3: 30-50 kg, NO 4: 50-70 kg, NO 5: >70 kg. After placement of the cLMA, it
will be inflated with air until the maximum recommended volume is reached and no leakage
sound is heard, and the maximum cuff pressure will be 60 cmH20. The time of LMA
insertion, resistance to LMA insertion (none, mild, moderate, severe), time to LMA
insertion (time from opening the mouth for insertion until confirmation of LMA insertion
by capnograph) and time of LMA cuff inflation will be noted on the patient evaluation
form. Anesthesia will be maintained with sevoflurane and remifentanyl infusion. For
postoperative pain, 1 mg/kg tramadol will be administered to both groups 15 minutes
before the end of surgery as an infusion in 150 ml isotonic saline solution to be
completed in 30 minutes. After the operation, when the patient starts breathing
spontaneously, the LMA will be removed and oral secretions will be gently aspirated with
a 14 F (French) soft aspiration catheter. The time of LMA removal, the duration of
positive pressure ventilation, the duration of surgery, whether there was bleeding during
the cleaning of oral secretions, whether there was blood on the LMA after LMA removal
will be noted on the patient evaluation form. After the patients recover in the operating
room, they will be transferred to the postoperative recovery room. Patients will be
observed in the recovery room for 1 hour in the postoperative period. Patients will be
asked about complaints of sore throat, dysphagia, dysphonia and cough at the 0th hour and
1st hour in the recovery room. Assessment of sore throat will be based on NRS (numeric
rating scale) pain score. Dysphagia, dysphonia and cough complaints will be noted as
present or absent. Patients will be sent to the services at the end of the 1st hour.
Complaints of sore throat, dysphagia, dysphonia and cough at postoperatively 6, 12 and 24
hours will be questioned and noted.