The Safety of Laryngeal Mask Airway-Assisted Bronchoscopy versus Standard Nasal Bronchoscopy.
BACKGROUND
The use of laryngeal mask airway (LMA) for fiberoptic bronchoscopy was first described in 1982. The LMA was found to be beneficial in operator view, flexibility, and also in maintaining stable oxygen saturation. Despite its advantages, the use of LMA has not become widespread.


OBJECTIVE
The aim of this paper was to evaluate the safety of LMA-assisted bronchoscopy compared to standard nasal bronchoscopy.


METHODS
We conducted a prospective randomized trial. The study group included 105 patients prospectively randomized to undergo either LMA-assisted (53 patients) or standard nasal bronchoscopy (52 patients). The data collected included continuous monitoring of respiratory and hemodynamic parameters and medication doses.


RESULTS
The LMA group had a significantly lower percentage of desaturation (pulse oximetry saturation [SpO2] <88%) events compared to the non-LMA (NLMA) group (37 vs. 63.4%; p = 0.008). The median percentage of time with SpO2 >88%, from the total procedure time, was 100% (IQR 98-100) in the LMA group and 98% (IQR 96-98) in the NLMA group (p = 0.003). Sedation in the LMA group required significantly higher doses of propofol (p < 0.001). The mean systolic blood pressure values were significantly lower in the LMA group, but this difference did not result in a higher percentage of clinically significant hypotension.


CONCLUSIONS
The use of LMA allows for better airway support, stable oxygen saturation, and a more convenient port of entry during flexible fiberoptic bronchoscopy. These results, together with the known advantages of the laryngeal mask, should lead to more widespread use in the evolving field of interventional pulmonology, in particular in high-risk patients and complicated procedures.
Department of Anesthesia, Rabin Medical Center, Petach Tikva, Israel.
Daniel
D
Alon
Barak
B
Pertzov
Evgeni
E
Gershman
Miryam
M
Frishman
Nader Abdel
NA
Rahman
Dror
D
Rosengarten
Mordechai R
MR
Kramer
D000368:Aged; D001784:Blood Gas Analysis; D001999:Bronchoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D009666:Nose; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies
D010100:Oxygen