Nasopharyngeal Airway Versus Laryngeal Mask Airway During Diagnostic Flexible Fiber-Optic Bronchoscope in Children

Pediatric fibreoptic diagnostic bronchoscope under general anesthesia using supraglottic devices as Laryngeal Mask Airway (LMA) and Nasopharyngeal Airway (NPA) are one of the variable techniques used for patient’s ventilation during this procedure.

We studied the effect of both devices on hypoxemia, the duration of the procedure, recovery time and the overall propofol consumption.

Ninety patients of both sexes, aged 5-10 years, American Society of Anesthesiology Class I & II scheduled for diagnostic fibreoptic bronchoscope under general anesthesia were divided randomly into two equal groups; LMA group & NPA group, during the procedure: heart rate, non invasive blood pressure, peripheral arterial oxygen saturation (SpO₂), arterial partial pressure of carbon dioxide (Pa CO₂), time of procedure, recovery time and total dose of propofol were measured and compared for each patient in both groups.

Hypoxemia & desaturation incidence was more in LMA group than in NPA group with highly significant difference (p-value 0.005). Also, the duration of procedure, recovery time in PACU, and total dose of propofol consumed were significantly less in the NPA group (p< 0.001) with no difference in hemodynamic status and PaCO₂.

The use of NPA as supraglottic ventilating device for children undergoing diagnostic flexible fibreoptic bronchoscopy is considered a good alternative for shortening the bronchoscopy time with less incidence of hypoxemia and better recovery time compared to LMA.