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Efficacy of a new dual channel laryngeal mask airway, the LMA®Gastro™ Airway, for upper gastrointestinal endoscopy: a prospective observational study

Terblanche, NCS, Middleton, C, Choi-Lundberg, DL ORCID: 0000-0002-3594-8585 and Skinner, M 2018 , 'Efficacy of a new dual channel laryngeal mask airway, the LMA®Gastro™ Airway, for upper gastrointestinal endoscopy: a prospective observational study' , British Journal of Anaesthesia, vol. 120, no. 2 , pp. 353-360 , doi: 10.1016/j.bja.2017.11.075.

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Abstract

Background: Significant cardiorespiratory events are frequent in patients undergoing gastrointestinal endoscopy. Centralto the occurrence of respiratory events is an unsecured airway. This study sought to determine the efficacy of a newlaryngeal mask airway, the LMA®GastroTM Airway (Teleflex Medical, Athlone, Ireland), in patients undergoing uppergastrointestinal endoscopy. New design features include a dedicated channel for oesophageal intubation and separatechannel with terminal cuff for lung ventilation.Methods: In a prospective, open label, observational study, 292 ASA physical status classification 1 and 2 patients at lowrisk of pulmonary aspiration undergoing upper gastrointestinal endoscopy received i.v. propofol anaesthesia andstandardized insertion of the LMA®GastroTM Airway. Endoscopy outcomes included insertion success, first attemptsuccess, and ease of endoscope insertion. LMA®GastroTM Airway outcomes included insertion success, first attemptsuccess, ease of insertion, lowest oxygen saturation, airway compromise, laryngospasm, bloodstained device, and sorethroat.Results: Per protocol analysis (n¼290), the endoscopy success rate amongst the cohort with successful LMA®GastroTMAirway insertion was 99% [95% confidence interval (CI): 98, 100]. LMA®GastroTM Airway insertion success rate (n¼292) was99% (95% CI: 98, 100). For endoscopy and LMA®GastroTM Airway insertion success, the lower limit of the 95% CIs was atleast 98%, indicating LMA®GastroTM Airway efficacy. Median (inter-quartile range) lowest intraoperative oxygen saturationwas 98% (98, 99). Only one serious adverse event occurred (re-admission for sore throat and inability to toleratefluids) and was reported to the Tasmanian Health and Medical Human Research Ethics Committee.CONCLUSIONS:The LMA®GastroTM Airway appears effective for clinical use in upper gastrointestinal endoscopy.

Item Type: Article
Authors/Creators:Terblanche, NCS and Middleton, C and Choi-Lundberg, DL and Skinner, M
Keywords: airway management, gastroenterology, laryngeal mask airway
Journal or Publication Title: British Journal of Anaesthesia
Publisher: Oxford Univ Press
ISSN: 0007-0912
DOI / ID Number: 10.1016/j.bja.2017.11.075
Copyright Information:

© 2017 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

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