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

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