Anaesthetic management of endobronchial ultrasound guided trans bronchial needle aspiration: Our experience with laryngeal mask airway
Journal Title: Indian Journal of Clinical Anaesthesia - Year 2018, Vol 5, Issue 4
Abstract
Introduction Endobronchial Ultrasound Guided Trans bronchial needle aspiration EBUSTBNA is a minimally invasive diagnostic modality for evaluating intra thoracic lymph nodes becoming one of the important tool in the armamentarium of pulmonologists The size of the fiberscope and sharing of the airway with the bronchoscopist poses unique challenges to the anesthesiologist In light of these developments it is important to develop an office based anesthesia technique for this relatively new procedure Hence we did this descriptive cohort studyAim To describe the accuracy and anaesthetic management of EBUSTBNA as a day care procedure done with general anesthesia GAMaterials and Methods Data was collected from January 2017 to December 2017 at our institute from patients who underwent EBUSTBNA under GA using second generation laryngeal mask airway LMA Specifically hemodynamic status Oxygen saturation duration of the procedure diagnostic yield and complications of the procedure were recordedResults 23 patients underwent EBUSTBNA under GA All patients were found to be hemodynamically stable with fluctuations in blood pressure and heart rate being less than 20 from the baseline with no episodes of desaturation The average number of biopsies taken is 33 with average duration of the procedure being 670176 meanSD minutes The incidence of post procedural complications like cough and sore throat were minimal Successful diagnostic yield was found in all cases with no incidence of recall of the procedureConclusion The performance of EBUSTBNA under general anesthesia with LMA provides great hemodynamic stability and adequate ventilation in a shared airway It demonstrates excellent diagnostic accuracy It provides comfort to the patient and the good examination conditions to the bronchoscopistClinical Significance Use of PLMA solves the dilemma of managing ventilation during EBUS TBNA without affecting the diagnostic yield of the procedure KeywordsEndobronchial ultrasound Trans bronchial needle aspiration LMA Propofol
Authors and Affiliations
Rashmi Rani, Arpana Kedlaya, Uma Devaraj, Priya Ramachandran
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