Faculty Collaboration Database

Laryngeal mask airway facilitated fibreoptic bronchoscopy in infants. Can J Anaesth 1997 Dec;44(12):1242-7

Date

01/16/1998

Pubmed ID

9429040

DOI

10.1007/BF03012770

Scopus ID

2-s2.0-0031408102 (requires institutional sign-in at Scopus site)   31 Citations

Abstract

PURPOSE: To assess the efficacy of the laryngeal mask airway (LMA) for fibreoptic bronchoscopy (FOB) and bronchoalveolar lavage (BAL) in infants.

METHODS: Observations were made in 19 consecutive infants undergoing FOB under general anaesthesia (GA) plus topical local anaesthesia. Anaesthesia was induced with N2O, O2, and halothane or sevoflurane except in two patients who received propofol and one who received thiopentone. Anaesthesia was maintained with oxygen and either sevoflurane, halothane, desflurane, or propofol infusion. No neuromuscular blockers were used. Size #1 or #2 LMAs were used through which a 3.5 mm fibreoptic bronchoscope was introduced. ECG, noninvasive blood pressure, pulse oximetry and, PETCO2 were measured. Intra- and post-procedural complications were recorded.

RESULTS: Mean age was 6 months; mean weight was 6.6 kg. Chronic wheezing was the indication for FOB in eight patients. Minor complications occurred in five patients: difficult LMA placement in one patient required changing size from #2 to #1; two patients had laryngospasm and bronchospasm that resolved with deepened anaesthesia and nebulised bronchodilator; one patient had transient arterial O2 desaturation, responding to increased FIO2, and one patient required tracheal intubation because ventilation via LMA became inadequate.

CONCLUSION: The minor complications observed were similar to other series and did not result in morbidity or mortality. We feel that GA via LMA facilitates safe FOB in infants. It affords excellent airway management, a quiet patient, and passage of a large fibreoptic bronchoscope for better imaging and suction channel required for BAL.

Author List

Bandla HP, Smith DE, Kiernan MP

Author

Hari Bandla MD Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Anesthesia
Bronchoalveolar Lavage Fluid
Bronchoscopy
Epiglottis
Female
Fiber Optic Technology
Humans
Infant
Laryngeal Masks
Male