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[Anaesthesia for bronchial echoendoscopy: experience with the laryngeal mask].

Abstract：

INTRODUCTION:Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) has recently been shown to be an accurate modality in the diagnosis and staging of mediastinal lymph node metastases. This procedure takes significantly longer than a conventional bronchoscopy and may therefore cause more discomfort. Since its introduction into respiratory practice in France, several airway management strategies have been used. PATIENTS AND METHODS:Both anaesthesia care and procedural sedation services share the goals of providing the patient with comfort during a potentially distressing procedure while also ensuring that the operating physician has an acceptable working environment. Historically, anaesthesiologists have applied the expertise gained in managing anaesthesia for major surgery to sedation care for minor procedures. While the supply of anaesthesiologists and anaesthetists has shown only a modest increase, the growth in minimally invasive procedures has been exponential in recent years. To investigate this further, we performed a retrospective study of the use of general anaesthetic with ventilation by a laryngeal mask during EBUS, which we have adopted in our unit. RESULTS:Sixty-three patients were included in the study. In 41 a laryngeal mask was used and in 22 the examination was performed under local anaesthetic alone. Eighty-seven percent of procedures were informative with cells from lymph nodes obtained (89% from examinations using laryngeal mask with a mean of 3.8 passes and 86% with sedation alone with a mean of 2.9 passes). In 45 cases (78%) it was possible to avoid mediastinoscopy. CONCLUSION:It was possible to establish a secure airway and maintain oxygenation with the laryngeal mask during bronchoscopy without any reduction in the success of the procedure.

journal_name

Rev Mal Respir

journal_title

Revue des maladies respiratoires

authors

Douadi Y,Bentayeb H,Malinowski S,Hoguet E,Lecuyer E,Boutemy M,Lachkar S,Fournier C,Dayen C

doi

10.1016/j.rmr.2009.11.004

subject

Has Abstract

pub_date

2010-01-01 00:00:00

pages

37-41

issue

eissn

0761-8425

issn

1776-2588

pii

S0761-8425(09)00011-4

journal_volume

pub_type

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[Anaesthesia for bronchial echoendoscopy: experience with the laryngeal mask].