Comparison of Efficacy of a Novel Dual Channel Gastro Laryngeal Mask Airway versus Nasal Prongs for Airway Management in Day Care Gastrointestinal Endoscopy Procedures: A Randomised Clinical Study

Abstract

Introduction: The Gastro Laryngeal Mask Airway (LMA) is a newer supraglottic airway device specifically designed for Gastroinstestinal (GI) endoscopy procedures. Hypoxia is a common complication in endoscopy procedures performed under sedation without securing the airway. The Gastro LMA allows for oxygenation, ventilation, and the passage of a gastroscope through its integrated endoscope channel. Aim: To evaluate the utility of the Gastro LMA compared to nasal prongs in maintaining oxygenation and airway control during upper GI endoscopy procedures. Materials and Methods: The present double-blinded randomised, single-centre clinical study conducted in the Department of Anaesthesiology, GCS Medical College Hospital and Research Centre, Ahmedabad, Gujarat, India included 50 adult patients scheduled for elective GI endoscopy procedures in the supine or lateral position. The patients were divided into two equal groups: Group G (Gastro LMA) and Group N (Nasal prong). Preprocedural heart rate and SpO2 levels were noted. All patients were observed for hypoxia (SpO2 <92%), bradycardia, lowest heart rate and Saturation of Peripheral Oxygen (SpO2 ) levels, conversion to endotracheal intubation, and any other intraoperative adverse events. Postoperatively, patients were observed for four hours for adverse effects and discharged after assessment using the modified Aldrete’s score. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 26.0, and the results were expressed as percentages, mean ± SD, and p-values. Results: Out of the 50 patients, 23 were male and 27 were female, with a median age of 59 years. The preprocedural mean lowest heart rate in Group G was 68/min, and in Group N it was 64/min. The mean lowest SpO2 during the procedure was 94% in Group N and 96% in Group G. In Group N, two patients (8%) required conversion to endotracheal intubation. One patient had a longer duration of the procedure and experienced bronchospasm, while another patient with Chronic Obstructive Pulmonary Disease (COPD) developed bronchospasm. In Group G, one patient (4%) required endotracheal intubation, possibly due to increased intrabdominal pressure caused by air insufflation in an obese patient. Conclusion: In patients undergoing gastrointestinal endoscopy procedures, the Gastro LMA appears to be effective for clinical use. It provides good airway control and enables deeper sedation without respiratory compromise. Ventilation was well maintained with minimal intraoperative and postoperative adverse events.