Use of laryngeal mask airway in flexible bronchoscopy in children
Use of laryngeal mask airway in flexible bronchoscopy in children
Aim: Flexible bronchoscope is widely used by pediatric pulmonologists as a diagnostic and therapeutic tool. The objective of thisstudy was to present our anesthesia experience in pediatric flexible bronchoscopy in which airway management was provided withlaryngeal mask airway (LMA) and the complications developed.Material and Methods: This study was conducted in children aged between 2-15 years who underwent bronchoscopy for diagnosisand/or treatment between January 2017 and November 2018. Patients’ demographic data, diagnosis, anesthesia and airwaymanagement were recorded from the patient files. Times of anesthesia, operation and recovery were recorded. Complicationsduring the procedure, awakening and recovery were recorded. Patients’ sore throat and hoarseness during resting and swallowingwere recorded.Results: This study included 31 patients whose airway management was provided with LMA. The mean age was 8.58±4.14years. Persistent cough was the most common indication for bronchoscopy (35.5%). Anesthesia time was 15.46±10.99 minutes,bronchoscopy time 12.87±10.57, awakening time 16.38±4.53 minutes, and recovery time 23.32±10.24 minutes. The most commoncomplication was cough (45.2%). Sore throats of the patients were observed as mild and moderate at the 0th and 2th hours. Bothresting and swallowing sore throats were observed as mild at the 4th hour, while no sore throat was seen in any patient at the 12thhour. Hoarseness was observed at mild level in 4 patients (12.9%) at the 0th hour.Conclusion: Providing airway with LMA in pediatric flexible bronchoscopy applications offers a safe anesthetic management, and ithas a low rate of complications.
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- 1. Nicolai T. Pediatric bronchoscopy. Pediatric Pulmonol
2001;31:150-64
- 2. Goudra BG, Singh PM, Borle A, et al. Anesthesia for Advanced
Bronchoscopic Procedures: State-of-the-Art Review. Lung
2015;193:453-65.
- 3. Chadha M, Kulshrestha M, Biyani A. Anaesthesia for
bronchoscopy. Indian J Anaesth 2015;59:565-73.
- 4. Abdelmalak B, Khanna A, Tetzlaff J. Fospropofol, a new
sedative anesthetic, and its utility in the perioperative
period. Curr Pharm Des 2012;18:6241-52.
- 5. Dhooria S, Sehgal IS, Aggarwal AN, et al. Diagnostic yield
and safety of cryoprobe transbronchial lung biopsy in
diffuse parenchymal lung diseases: systematic review and
meta-analysis. Respir Care 2016;61:700-12.
- 6. Garnock-Jones KP, Scott LJ. Fospropofol. Drugs
2010;70:469-77.
- 7. Wood RE, Parakash UBS. Pediatric flexible bronchoscopy.
In: Parakash UBS, editor. Bronchoscopy. New York: Raven
Press; 1994. p 345-56.
- 8. Masters IB, Cooper P. Position paper. Pediatric flexible
bronchoscopy. J Pediatr Child Health 2002;38:555-9.
- 9. KabirAL, Majumder JU, Mridha AA, et al. Pediatric flexible
fiberoptic bronchoscopy. Bangladesh J Child Heal
2010;29:99-103.
- 10. Nussbaum E. Pediatric fiberoptic bronchoscopy: clinical
experience with 2,836 bronchoscopies. Pediatr Crit Care
Med 2002;3:171-6.
- 11. Nicolai T. The role of rigid and flexible bronchoscopy in
children.Paediatr Respir Rev 2011;12:190-5.
- 12. Manna SS, Durward A, Moganasundram S, et al.
Retrospective evaluation of a paediatric intensivistled
flexible bronchoscopy service. Intensive Care Med
2006;32:2026-33.
- 13. Rai MR, Parry TM, Dombrovskis A, et al. Remifentanil targetcontrolled
infusion vs propofol target-controlled infusion
for conscious sedation for awake fibreoptic intubation: a
doble-blinded randomized controlled trial. Br J Anaesth
2008;100:125-30.
- 14. Aldrete JA. The post-anesthesia recovery score revisited. J
Clin Anesth1995;7:89-91
- 15. Maggie L, Naguib MD, Daniel S, et al. Use of laryngeal mask
airway in flexible bronchoscopy in ınfants and children
Pediatric Pulmonol 2005;39:56-63
- 16. Schramm D, Yu Y, Wiemers A, et al. Pediatric flexible and
rigid bronchoscopy in European centers-Availability and
current practice. Pediatr Pulmonol 2017;52:1502-1508.
- 17. Balfour-Lynn IM, Spencer H. Bronchoscopy-how and when?
Series: flexible bronchoscopy in children—the Brompton
experience. Pediatr Respir Rev 2002;3:255-64.
- 18. Terkawi RS, Altirkawi KA, Terkawi AS, et al. Flexible
bronchoscopy in children: Utility and complications. Int J
Pediatr Adolesc Med 2016;3:18-27.
- 19. Rodrı´guez Martı´nez C, Sossa MP. Factors associated
with complications caused by bronchoscopy in pediatric
patients. Arch Bronconeumol 2003;39:501-6
- 20. Malherbe S, Whyte S, Singh P, et al. Total intravenous
anesthesia and spontaneous respiration for airway
endoscopy in children e a prospective evaluation. Paediatr
Anaesth 2010;20:434-8.
- 21. Kim ES, Kim EC, Lee SM, et al. Bacterial yield from quantitative
cultures of bronchoalveolar lavage fluid in patients with
pneumonia on antimicrobial therapy. Korean J Intern Med.
2012;27:156-62.