Efficacy of a new dual channel laryngeal mask airway, the LMA®Gastro™ Airway, for upper gastrointestinal endoscopy: a prospective observational study

Background: Significant cardiorespiratory events are frequent in patients undergoing gastrointestinal endoscopy. Central to the occurrence of respiratory events is an unsecured airway. This study sought to determine the efficacy of a new laryngeal mask airway, the LMA^®Gastro^TM Airway (Teleflex Medical, Athlone, Ireland), in patients undergoing upper gastrointestinal endoscopy. New design features include a dedicated channel for oesophageal intubation and separate channel with terminal cuff for lung ventilation.

Methods: In a prospective, open label, observational study, 292 ASA physical status classification 1 and 2 patients at low risk of pulmonary aspiration undergoing upper gastrointestinal endoscopy received i.v. propofol anaesthesia and standardized insertion of the LMA^®Gastro^TM Airway. Endoscopy outcomes included insertion success, first attempt success, and ease of endoscope insertion. LMA^®Gastro^TM Airway outcomes included insertion success, first attempt success, ease of insertion, lowest oxygen saturation, airway compromise, laryngospasm, bloodstained device, and sore throat.

Results: Per protocol analysis (n¼290), the endoscopy success rate amongst the cohort with successful LMA^®Gastro^TM Airway insertion was 99% [95% confidence interval (CI): 98, 100]. LMA^®Gastro^TM Airway insertion success rate (n¼292) was 99% (95% CI: 98, 100). For endoscopy and LMA^®Gastro^TM Airway insertion success, the lower limit of the 95% CIs was at least 98%, indicating LMA^®Gastro^TM Airway efficacy. Median (inter-quartile range) lowest intraoperative oxygen saturation was 98% (98, 99). Only one serious adverse event occurred (re-admission for sore throat and inability to tolerate fluids) and was reported to the Tasmanian Health and Medical Human Research Ethics Committee.

CONCLUSIONS: The LMA^®GastroTM Airway appears effective for clinical use in upper gastrointestinal endoscopy.