BACKGROUND Nonoperating room anesthesia during gastroenterological procedures is a growing field in anesthetic practice. While the numbers of patients with severe comorbidities are rising constantly, gastrointestinal endoscopic interventions are moving closer to minimally invasive endoscopic surgery. The LMA Gastro™ is a new supraglottic airway device, developed specifically for upper gastrointestinal endoscopy and interventions. The aim of this study was to evaluate the feasibility of LMA Gastro™ in patients with ASA physical status ≥3 undergoing advanced endoscopic procedures. METHODS We analyzed data from 214 patients retrospectively who received anesthesia for gastroenterological interventions. Inclusion criteria were upper gastrointestinal endoscopic interventions, airway management with LMA Gastro™ and ASA status ≥3. The primary outcome measure was successful use of LMA Gastro™ for airway management and endoscopic intervention. RESULTS Thirtyone patients with ASA physical status ≥3, undergoing complex and prolonged upper gastrointestinal endoscopic procedures were included. There were 7 endoscopic retrograde cholangiopancreatographies, 7 peroral endoscopic myotomies, 5 percutaneous endoscopic gastrostomies and 12 other complex procedures (e.g. endoscopic submucosal dissection, esophageal stent placement etc.). Of these, 27 patients were managed successfully using the LMA Gastro™. Placement of the LMA Gastro™ was reported as easy. Positive pressure ventilation was performed without difficulty. The feasibility of the LMA Gastro™ for endoscopic intervention was rated excellent by the endoscopists. In four patients, placement or ventilation with LMA Gastro™ was not possible. CONCLUSIONS We demonstrated the feasibility of the LMA Gastro™ during general anesthesia for advanced endoscopic procedures in high-risk patients. TRIAL REGISTRATION German Clinical Trials Register (DRKS00017396) Date of registration: 23rd May 2019, retrospectively registered.

中文翻译：

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LMA Gastro™气道在高危患者的上消化道内镜手术过程中是可行的：一项单中心观察性研究。

背景技术胃肠外科手术期间的非手术室麻醉是麻醉实践中的增长领域。尽管患有严重合并症的患者人数不断增加，但胃肠道内窥镜干预正逐渐接近微创内窥镜手术。LMA Gastro™是一种新的声门上气道设备，专门为上消化道内窥镜检查和介入治疗而开发。这项研究的目的是评估LMA Gastro™在接受高级内窥镜检查的ASA身体状况≥3的患者中的可行性。方法我们回顾性分析了214例接受胃肠道手术麻醉的患者的数据。纳入标准为上消化道内镜干预，LMA Gastro™和ASA状态≥3的气道管理。主要结果指标是将LMA Gastro™成功用于气道管理和内窥镜干预。结果纳入了ASA身体状况≥3，接受复杂且长期的上消化道内镜手术的31例患者。有7例内镜逆行胰胆管造影术，7例经口内镜下肌切开术，5例经皮内镜下胃造口术和12例其他复杂手术（例如内镜下黏膜下剥离术，食管支架置入术等）。其中，有27名患者使用LMA Gastro™成功治疗。据报道，放置LMA Gastro™很容易。进行正压通气没有困难。内镜医师将LMA Gastro™用于内窥镜干预的可行性评为“极佳”。在四位病人中 无法使用LMA Gastro™放置或通风。结论我们证明了LMA Gastro™在全身麻醉期间对高危患者进行高级内镜手术的可行性。试用注册德国临床试验注册（DRKS00017396）的注册日期：2019年5月23日，进行追溯注册。