Comparison of first-attempt endoscope insertion success between LMA® Gastro™ and low-flow nasal cannula during upper gastrointestinal endoscopy: A prospective randomised controlled trial.

BACKGROUND AND AIMS: Upper gastrointestinal (GI) endoscopic procedures under total intravenous anaesthesia (TIVA) pose risks of sedation-related complications. This study compared the first-attempt endoscope insertion success between the Laryngeal Mask Airway® (LMA) Gastro™ and low-flow nasal cannula during upper GI endoscopy under TIVA.

METHODS

This prospective randomised controlled study involved 140 adult patients scheduled for upper GI endoscopy under TIVA. The participants were randomly assigned into two groups: Group L (LMA® Gastro™) and Group C (low-flow nasal cannula). In Group L, LMA® Gastro™ was inserted, and in Group C, oxygen was supplemented using a low-flow nasal cannula at 4 litres/min. The primary outcome was first-attempt success of endoscope insertion. Secondary outcomes included endoscope insertion time, endoscopist and anaesthesiologist satisfaction scores, and intra- and postoperative complications. Data were analysed using statistical package for social sciences (SPSS) 19.0, and P < 0.05 was considered statistically significant.

RESULTS

The first-attempt success rate for endoscope insertion was comparable between the groups (Group L: 92.6% vs. Group C: 95.7%, P = 0.44). However, the endoscopy insertion time was significantly prolonged in Group L (Median [interquartile range] (seconds): 30 [22-41] vs. 17.5 [13-22], P < 0.001). Anaesthesiologist satisfaction was comparable between the groups, but endoscopists were more satisfied with Group C (P < 0.001). Group L had significantly fewer intraoperative respiratory adverse events compared with Group C; however, a higher incidence of postoperative sore throat was observed in Group L (20.5%).

CONCLUSION

The first-attempt endoscope insertion success rate was comparable between the LMA® Gastro™ and nasal cannula groups in patients undergoing upper GI endoscopy under TIVA.