Abstract

Anaesthesia for Endobronchial Ultrasound-Guided Procedures Using i-gel

Author(s): M. K. M. Kathyayani, M. Hari Bhanu Teresa

BACKGROUND Advancements in the field of EBUS (endobronchial ultrasound) and its applications in the field of interventional pulmonology made it important to develop an officebased out-patient anaesthesia technique for this minimally invasive procedure. The increasing scope of applications in the field of EBUS made the stability and necessity of airway access as one of the determining factors not only for the safety of the patient, but also to cater to the widened horizon of its applications including TBNA, Cryotherapy etc. i-gel as supraglottic airway device can be used for therapeutic intervention procedures like EBUS, TBNA, while providing a secure airway to the anesthetized patient. We wanted to evaluate the efficacy of i-gel for EBUS procedures. METHODS For this observation study, 60 patients of ASA grade: 1-3 scheduled for elective EBUS were included. Patients with limited mouth opening or with airway abscess were excluded from the study. Preoperative oxygen saturation, chest X-ray, ECG, CT chest scan, intra-operative ease of airway access, airway stability (adequate oxygen saturation) were tested taking into consideration the surgeon’s comfort, need for emergency treatment or abandoning procedure, post-operative time for extubation, associated complications, readiness for discharge and surgeon. RESULTS The incidence of adverse events during peri-operative period was low and none of the patients suffered hypoxia (SpO2 <90%). During emergency, 4 patients had cough, 1 patient had bronchospasm and 2 patients complained of sore throat. No considerable variations of baseline haemodynamics were seen with insertion or during removal of i-gel. CONCLUSIONS i-gel as supraglottic airway device can be used for therapeutic intervention procedures like EBUS, TBNA, while providing a secure airway to the anesthetized patient.

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