Laryngeal mask airway application during flexible fiberoptic bronchoscopy in pediatric patients: Evaluation of 125 cases


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Keskin G., Akin M., Senayli Y. , Saydam S., Kurt D. T. , Özmert S., ...More

Anestezi Dergisi, vol.27, no.2, pp.24-29, 2019 (Refereed Journals of Other Institutions) identifier

  • Publication Type: Article / Article
  • Volume: 27 Issue: 2
  • Publication Date: 2019
  • Doi Number: 10.5222/jarss.2019.36025
  • Title of Journal : Anestezi Dergisi
  • Page Numbers: pp.24-29
  • Keywords: Child, Flexible fiberoptic bronchoscopy, Laryngeal mask airway

Abstract

© Copyright Anesthesiology and Reanimation Specialists' Society.Objective: The use of the laryngeal mask airway (LMA) during flexible fiberoptic bronchoscopy (FFB) is more advantageous compared to other airway devices. In this study, it was planned to evaluate, the success rates of the usage of LMA for airway maintenance in pediatric patients in FFB and the postoperative complications encountered, together with demographic characteristics, ASA risk groups, duration of anesthesia and bronchoscopic diagnoses of patients, in the light of the literature. Methods: The files of pediatric patients who underwent FFB between March 2013 and October 2015 were reviewed retrospectively. Demographic data of the patients, airway devices used for airway maintenance in FFB (LMA, endotracheal tube, face mask), indications of bronchoscopy, bronchoscopic diagnoses, duration of anesthesia, postprocedural desaturation, laryngospasm, bronchospasm, and the number of patients requiring reintubation were recorded. Results: A total of 125 children with an age range of 7 days-18 years were included in the study. The median age of the patients was found to be 44 months (interquartile range 11.5-124 months), and median weight was 15 kg (interquartile range 8-30 kg). The most common indication for FFB was recurrent lung infection (26.4%). LMA was successfully performed in 95.9% of the patients. In total, 7 (5.6%) patients had temporary hypoxia and 1 (0.8%) had bronchospasm. Two patients were intubated and transferred into intensive care unit. Multivariate logistic regression test showed that the duration of anesthesia lasting longer than 45 minutes increased the risk of complications 7 times. Conclusion: FFB via LMA is a safe method in the pediatric patient group. The risk of complications increases with the duration of anesthesia, rather than with ASA risk group, age, weight and dimensions of LMA.