Use of the gastro-laryngeal tube in endoscopic retrograde cholangiopancreatography cases under sedation/analgesia

Daşkaya, Hayrettin; Uysal, Harun; Çiftçi, Taner; Baysal, Birol; İdin, Kadir; Karaaslan, Kazım

doi:10.5152/tjg.2016.16121

Cited by 12 publications

(9 citation statements)

References 12 publications

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“…Reasons for desaturation during ERCP under deep sedation have been attributed to reduced cardiopulmonary reserve, advanced age, respiratory depression, duration of the procedure, and prone positioning. The incidence of hypoxemia during any endoscopic procedure is in the range of 11%-50% [5][6][7] and it is possibly as high as 60% with ERCP [8] (definitions of hypoxia vary between the studies). Prolonged hypoxia is a major risk factor for periprocedural cardiac arrhythmias and myocardial ischaemia [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

High-flow nasal cannula versus standard oxygen therapy assisting sedation during endoscopic retrograde cholangiopancreatography in high risk cases (OTHER): study protocol of a randomised multicentric trial

Thiruvenkatarajan

Dharmalingam

Arenas

et al. 2020

Trials

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Background: Endoscopic retrograde cholangiopancreatography (ERCP) is an increasingly common intervention in the treatment of pancreaticobiliary disorders. Patients are often elderly with complex co-morbidities. While monitored anaesthesia care with sedation is commonly used for most cases, few would require general anaesthesia with an endotracheal tube. Both low-flow and high-flow nasal cannulas (HFNC) are established ways of delivering supplemental oxygen, but it is unclear whether one technique is better than the other. HFNC seems a promising tool for advanced procedures but evidence to support its application in high-risk ERCP cases is limited. The rate of oxygen desaturation during endoscopy has been reported to be as high as 11%-50% and the method of oxygen delivery for ERCP merits further study. Methods/design: This is a prospective, randomised, multicentre trial comparing the efficacy of oxygen supplementation through HFNC versus low-flow nasal cannula during ERCP, in a cohort of patients at risk of adverse respiratory events. A total of 132 patients will be recruited across three sites and randomly assigned to either the low-flow or the HFNC group. The primary outcome is the proportion of patients experiencing hypoxia, defined by any event of SpO2 < 90%. The secondary outcomes include parameters centred on oxygenation, requirement of airway manoeuvres, successful completion of procedure, perioperative complications, patient satisfaction and cost analysis of the consumables. An intention-to-treat principle will be applied while analysing.

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Section: Introductionmentioning

confidence: 99%

High-flow nasal cannula versus standard oxygen therapy assisting sedation during endoscopic retrograde cholangiopancreatography in high risk cases (OTHER): study protocol of a randomised multicentric trial

Thiruvenkatarajan

Dharmalingam

Arenas

et al. 2020

Trials

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“…Moderate to deep sedation is a commonly employed technique for ERCPs, with general anaesthesia utilising an endotracheal intubation being reserved for selected cases. Reported rates of hypoxemia during all endoscopic procedures range from 11 to 50% [1][2][3], and this may be as high as 60% with ERCP [4]. (Definitions of hypoxia vary between the studies.)…”

Section: Introductionmentioning

confidence: 99%

“…Various airway techniques have been employed for endoscopic procedures, aiming to avoid hypoxia, and obtain better airway control. These include the standard laryngeal mask airway (LMA), gastro-laryngeal tube (GLT), endoscopy mask, a specialised bite block and nasal positive pressure delivery devices [4,[8][9][10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

LMA® Gastro™ Airway for endoscopic retrograde cholangiopancreatography: a retrospective observational analysis

et al. 2020

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Background: Various airway techniques have been employed for endoscopic procedures, with an aim to optimise patient outcomes by improving airway control and preventing hypoxia whilst avoiding the need for intubation. The LMA® Gastro™ Airway, a novel dual channel supraglottic airway technique, has been described as such a device. Its utility alongside sedation with low flow nasal cannula and general anaesthesia (GA) with intubation for endoscopic retrograde cholangiopancreatography (ERCP) procedures was evaluated. Methods: Details of all the ERCPs performed in our institution from March 2017 to June 2018 were carefully recorded in the patients' electronic case records. Data on the successful completion of ERCP through LMA® Gastro™ Airway; any difficulty encountered by the gastroenterologists; and adverse events were recorded. Episodes of hypoxia (SpO 2 < 92%) and haemodynamic parameters were compared across the three groups: LMA® Gastro™ vs. sedation with low flow nasal cannula vs. GA with an endotracheal tube (ETT). Results: One hundred seventy-seven ERCP procedures were performed during the study period. The LMA® Gastro™ Airway was employed in 64 procedures (36%) on 59 patients. Of these 64 procedures, ERCP was successfully completed with LMA® Gastro™ Airway in 63 (98%) instances, with only one case requiring conversion to an endotracheal tube. This instance followed difficulty in negotiating the endoscope through LMA® Gastro™ Airway. No episodes of hypoxia or hypercapnia were documented in both LMA® Gastro™ and GA with ETT groups. One sedation case with nasal cannula was noted to have hypoxia. Adverse intraoperative events were recognised in 2 cases of LMA® Gastro™: one had minimal blood stained secretions from the oral cavity that resolved with suctioning; the other developed mild laryngospasm which resolved spontaneously within a few minutes.

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“…The ideal anesthesia method for endoscopic procedures is still controversial. This debate is due to the lack of standardization of significant numbers of procedures in terms of method, duration and degree of invasiveness, and the high comorbidity and age in the patient profile 1 . The quality of anesthesia administered may be different depending on the patient's comorbid disease status and possible complications.…”

Section: Introductionmentioning

confidence: 99%

Analysis of anesthesia administration in the endoscopy unit in terms of patient profile and complications: Retrospective Study

Uysal¹,

Daşkaya²

2019

MMJ

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Objective: This study aimed to analyze patients undergoing endoscopic interventions in terms of comorbid diseases, preoperative anesthesia management predictions, intraoperative-postoperative complications and requirements for intensive care. Method: Records of patients who underwent procedures under anesthesia in the endoscopy unit were retrospectively screened. The patients' preoperative anesthesia evaluation, intraoperative anesthesia, and postoperative recovery data and intensive care monitoring requirements were recorded. The data obtained were analyzed statistically. Results: It was identified that the preoperative risk prediction of patients was statistically significant for intraoperative and postoperative monitoring. Comorbid disease and high age were determined to increase the requirements for intensive care after the procedure. Increased need for qualified admission was determined in patients with desaturation and hypotension. Conclusion: A prerequisite for reliable administration of anesthesia is having detailed information about the patient and being prepared for possible complications. When examined from this aspect, analysis of the patient profile undergoing procedures in the endoscopy unit is important. In our study, we revealed the presence of elderly patients and comorbid disease(s) in the patient group who underwent procedures in this unit. The need for detailed preliminary evaluation of the patients undergoing these types of procedure and requirements for intensive care after the procedure, if necessary, should definitely be considered.

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Use of the gastro-laryngeal tube in endoscopic retrograde cholangiopancreatography cases under sedation/analgesia

Cited by 12 publications

References 12 publications

High-flow nasal cannula versus standard oxygen therapy assisting sedation during endoscopic retrograde cholangiopancreatography in high risk cases (OTHER): study protocol of a randomised multicentric trial

High-flow nasal cannula versus standard oxygen therapy assisting sedation during endoscopic retrograde cholangiopancreatography in high risk cases (OTHER): study protocol of a randomised multicentric trial

LMA® Gastro™ Airway for endoscopic retrograde cholangiopancreatography: a retrospective observational analysis

Analysis of anesthesia administration in the endoscopy unit in terms of patient profile and complications: Retrospective Study

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