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Flexible fibreoptic bronchoscopy via the laryngeal mask
Author(s) -
DichNielsen J. O.,
Nagel P.
Publication year - 1993
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1993.tb03589.x
Subject(s) - medicine , bronchoscopy , flexible bronchoscopy , laryngeal mask airway , laryngeal masks , laryngoscopes , larynx , laryngoscopy , anesthesia , surgery , intubation , airway
The efficacy of flexible fibreoptic bronchoscopy through the laryngeal mask was investigated in 20 patients under total intravenous anaesthesia with propofol, fentanyl, atropine and suxamethonium. Mask size 4 was used for men and size 3 for women. Ventilation was performed with oxygen in air, F IO 2 0.6. The ventilatory pressures were median 18 (9–40) cmH 2 O (1.8 (0.9–3.9) kPa) before the bronchoscope was inserted. When the tip of the bronchoscope was above the vocal cords the ventilatory pressures increased to 22 (10–43) mmHg (2.2(1.0–4.2) kPa) ( P <0.001), and when the tip was situated at the mid‐tracheal level there was a further increase to 24 (12–50) mmHg (2.4(1.2–4.9) kPa) ( P <0.001). Maximal gas leakages were median 1 (0–2) 1/min ‐1 . PEEP at the mid‐tracheal level was 3 (0–7) cmH 2 O (0.3(0–0.7) kPa). When 15 min of the procedure had elapsed, Pao 2 was 232 (112–350) mmHg (30.9(14.9–46.6) kPa) and Paco 2 39 (33–46) mmHg (5.2(4.4–6.1) kPa). The lowest oxygen saturation was median 98 (96–100)% and the highest end‐tidal CO 2 34 (24–41) mmHg (4.5(3.2–5.5) kPa). It was easy to examine the laryngeal opening and a good assessment of vocal cord function was allowed when muscle relaxation ceased. We conclude that flexible fibreoptic bronchoscopy through the laryngeal mask is a safe technique provided that total intravenous anaesthesia is used. It is a valuable alternative to flexible bronchoscopy performed with topical anaesthesia.