Case Report
Volume 9 Issue 8 - 2022
Gastro LMA: An Ideal Airway Device in High Risk Geriatric Patients Scheduled for Life Saving Gastroendoscopic Procedures
Anurag Garg1* and Soham Das2
11Consultant (Anaesthesiology), Army Hospital (Research and Referral), New Delhi, India
2Resident (Anaesthesiology), Army Hospital (Research and Referral), New Delhi, India
*Corresponding Author: Anurag Garg, Consultant (Anaesthesiology), Army Hospital (Research and Referral), New Delhi, India.
Received: June 18, 2022; Published: August 19, 2022




Abstract

With the advancement of modern medical science the range of endoscopic procedures being carried out in gastro endoscopic (GE) suites have increased dramatically. These procedures are usually day care procedures, the endoscopistic prefer to perform the procedure in GE suite, in order to have early recovery and cost benefit. The use of supraglottic airway device usually reduces anaesthetic dose requirements and has shorter recovery time compared to tracheal intubation. With the introduction of Gastro LMAR in the armamentarium of anaesthesiologists, the so called above mentioned, high risk procedures have become easier to manage.

We would share our experience of a similar High risk geriatric case which was successfully conducted using Gastro LMA for airway control.

77 years old hypertensive female a known cardiac patient with history of Hypertrophic Obstructive Cardiomyopathy had undergone Percutaneous Transluminal Septal Myocardial Ablation (PTSMA) and then developed complete heart block and was on pacemaker since last 5 years. Patient also had cerebrovascular accident (CVA) of right parietal region 3 years back and was on dual antiplatelets. Such, high risk patient with multiple co morbidities had developed choledocholithiasis and was planned for ERCP.

After careful preanaesthetic checkup (PAC) patient was accepted in ASA 3 for Endoscopic Retrograde Cholangiography (ERCP) and was advised to be taken up for ERCP procedure after optimization of her physical condition and comorbidities. The case was conducted smoothly using gastro LMA for airway protection.

Keywords: Gastroendoscopic Procedures; Gastro LMA; Endoscopic Retrograde Cholangiography (ERCP); Cardiovascular Disease; Pacemaker

References

  1. Smith ZL., et al. “A randomized controlled trial evaluating general endotracheal anesthesia versus monitored anesthesia care and the incidence of sedation-related adverse events during ERCP in high-risk patients”. Gastrointestinal Endoscopy4 (2019): 855-862.
  2. Osborn IP., et al. “Laryngeal mask airway-a novel method of airway protection during ERCP: comparison with endotracheal intubation”. Gastrointestinal Endoscopy1 (2002): 122-128.
  3. Terblanche NCS., et al. “Efficacy of a new dual channel laryngeal mask airway, the LMA® Gastro? Airway, for upper gastrointestinal endoscopy: a prospective observational study”. British Journal of Anaesthesia2 (2018): 353-360.
  4. Hagan KB., et al. “Safety of the LMA® Gastro? for endoscopic retrograde cholangiopancreatography”. Anesthesia and Analgesia5 (2020): 1566-1572.
  5. Schmutz A., et al. “LMA Gastro? airway is feasible during upper gastrointestinal interventional endoscopic procedures in high risk patients: a single-center observational study”. BMC Anesthesiology1 (2020): 40.
  6. Tran A., et al. “LMA® Gastro? Airway for endoscopic retrograde cholangiopancreatography: a retrospective observational analysis”. BMC Anesthesiology1 (2020): 113.
  7. Patel S., et al. “Deep sedation occurs frequently during elective endoscopy with meperidine and midazolam”. The American Journal of Gastroenterology 100 (2005): 2689-2695.
  8. Sorser SA., et al. “Complications of ERCP in patients undergoing general anesthesia versus MAC”. Digestive Diseases and Sciences 59 (2014): 696-697.
  9. Schmutz A., et al. “LMA Gastro™ airway is feasible during upper gastrointestinal interventional endoscopic procedures in high risk patients: a single-center observational study”. BMC Anesthesiologica1 (2020): 40.
  10. Uysal H., et al. “Comparison of LMA® Gastro Airway and Gastro-Laryngeal Tube in endoscopic retrograde cholangiopancreatography: a prospective randomized observational trial”. Minerva Anestesiologica9 (2021): 987-996.
Citation: Anurag Garg and Soham Das. “Gastro LMA: An Ideal Airway Device in High Risk Geriatric Patients Scheduled for Life Saving Gastroendoscopic Procedures”. EC Gastroenterology and Digestive System 9.9 (2022): 01-04.

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