title: Flexible fibreoptic bronchoscopy via the laryngeal mask.
abstract: The efficacy of flexible fibreoptic bronchoscopy through the laryngeal mask was investigated in 20 patients under total intravenous anaesthesia with propofol, fentanyl, atropine and suxamethonium. Mask size 4 was used for men and size 3 for women. Ventilation was performed with oxygen in air, FIO2 0.6. The ventilatory pressures were median 18 (9-40) cmH2O (1.8 (0.9-3.9) kPa) before the bronchoscope was inserted. When the tip of the bronchoscope was above the vocal cords the ventilatory pressures increased to 22 (10-43) mmHg (2.2 (1.0-4.2) kPa) (P < 0.001), and when the tip was situated at the mid-tracheal level there was a further increase to 24 (12-50) mmHg (2.4 (1.2-4.9) kPa) (P < 0.001). Maximal gas leakages were median 1 (0-2) l/min-1. PEEP at the mid-tracheal level was 3 (0-7) cmH2O (0.3(0-0.7) kPa). When 15 min of the procedure had elapsed, PaO2 was 232 (112-350) mmHg (30.9 (14.9-46.6) kPa) and PaCO2 39 (33-46) mmHg (5.2(4.4-6.1) kPa). The lowest oxygen saturation was median 98 (96-100)% and the highest end-tidal CO2 34 (24-41) mmHg (4.5(3.2-5.5) kPa). It was easy to examine the laryngeal opening and a good assessment of vocal cord function was allowed when muscle relaxation ceased. We conclude that flexible fibreoptic bronchoscopy through the laryngeal mask is a safe technique provided that total intravenous anaesthesia is used. It is a valuable alternative to flexible bronchoscopy performed with topical anaesthesia.
authors.affiliation: Department of Anaesthesia, Skive Hospital, Denmark.
authors.forename: J O
authors.initials: JO
authors.lastname: Dich-Nielsen
authors.forename: P
authors.initials: P
authors.lastname: Nagel
mesh_terms: D000328:Adult; D000368:Aged; D000771:Anesthesia, Intravenous; D001999:Bronchoscopy / Q000379:methods*; D005260:Female; D005283:Fentanyl; D005336:Fiber Optic Technology; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D015742:Propofol
chemical_list: D005283:Fentanyl; D015742:Propofol