SAFETY OF LARYNGEAL MASK AIRWAY USE WITH GENERAL ANASTHESIA DURING INTERVENTIONAL BRONCHOSCOPIC PROCEDURES

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SESSION TITLE: Procedures Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: General anesthesia can be used with more advanced bronchoscopy procedures to help with patient tolerance and outcomes for procedures that may be more prolonged . The use of endotracheal tubes prevents complete evaluation of the trachea and upper airway for some procedures, while a laryngeal mask airway (LMA) can help provide a protected airway for deeper sedation and anesthesia and improve upper airway visualization. The purpose of our study is to evaluate the safety, efficacy profile, and outcomes of using LMA for upper airway management during interventional bronchoscopy procedures under general anesthesia. METHODS: We performed a retrospective, single center chart review, analyzing data from 295 patients undergoing bronchoscopic procedures between August 2017-October 2018. Of the 290 patients who had general anesthesia for their procedures, 117 patients (41%) had an LMA placed during their procedures. Almost all those procedures were convex probe EBUS bronchoscopies. RESULTS: Our patient population was 46% male; 48% white, 52 % were African-American and 1% were Hispanic . The median age was 68 years-old and average BMI mean was 28. Many patients have multiple medical comorbidities, with ASA -2 in 21 % , ASA-3 in 67% , and ASA-4 in 12% of the patients. Procedure times averaged 71 minutes in LMA group, and 81 minutes in non-LMA group. Seven (6 %) patients had their LMA changed to ETT to complete their procedures due to inadequate ventilation. There were no cardiac complications (acute coronary syndrome, decompensated heart failure) following anesthesia. One patient had hypoxic respiratory failure that required hospital admission for 1 day. One patient had post procedure nausea. Transient intra-procedural hypotension did happen in 13 patients (15%) that resolved by the end of the procedure with use of IVF fluid and small dose of IV vasopressors. CONCLUSIONS: In general, there were no difficulties with airway maintenance during the procedures. All of the procedures were able to be completed without interruption or delay and recovered without significant incident. LMA is a safe device to use during general anesthesia with interventional bronchoscopies procedures even with advanced ASA scores. CLINICAL IMPLICATIONS: During Interventional bronchoscopic procedures ( especially convex probe EBUS), LMA uses provide safe and feasible method to manage the upper airway during general anesthesia. DISCLOSURES: No relevant relationships by Ammar Alqaid, source=Web Response No relevant relationships by Rishi Arora, source=Web Response No relevant relationships by David Chambers, source=Web Response No relevant relationships by Allen Elster, source=Web Response No relevant relationships by Paul Fisher, source=Web Response Site Investigator for EMPROVE relationship with Olympus-Spiration Please note: $1001 - $5000 Added 06/15/2020 by Robert Holladay, source=Web Response, value=Grant/Research Support Site Investigator for DAS 181 relationship with Ansun pharmaceutical Please note: $1001 - $5000 Added 06/15/2020 by Robert Holladay, source=Web Response, value=Grant/Research Support No relevant relationships by Aditya Sithamraju, source=Web Response