LARYNGEAL MASK AIRWAY FACILITATED FIBEROPTIC BRONCHOSCOPY IN INFANTS

Purpose: To assess the efficacy of the laryngeal mask airway (IMA) for fibreoptic bronchoscopy (FOB) and bronchoalveolar lavage (BAL) in inf ants, Methods: Observations were made in 19 consecutive infants underg oing FOE under general anaesthesia (GA) plus topical local anaesthesia , Anaesthesia was induced with N2O, O-2, and halothane or sevoflurane except in two patients who received propofol and one who received thio pentone, Anaesthesia was maintained with oxygen and either sevoflurane , halothane, desflurane, or propofol infusion. No neuromuscular blocke rs were used. Size not equal 1 or #2 LMAs were used through which a 3. 5 mm fibreoptic bronchoscope was introduced. ECG, noninvasive blood pr essure, pulse oximetry and, PETCO2 were measured. Intra-and post-proce dural complications were recorded. Results: Mean age was 6 months; mea n weight was 6.6 kg, Chronic wheezing was the indication for FOB in ei ght patients. Minor complications occurred in five patients: difficult LMA placement in one patient required changing size from #2 to #1; tw o patients had laryngospasm and bronchospasm that resolved with deepen ed anaesthesia and nebulised bronchodilator; one patient had transient arterial O-2 desaturation responding to increased FIO2, and one patie nt required tracheal intubation because ventilation via IMA became ina dequate, Conclusion: The minor complications observed were similar to other series and did not result in morbidity or mortality. We feel tha t GA via IMA facilitates safe FOE in infants, it affords excellent air way management, a quiet patient, and passage of a larger fibreoptic br onchoscope for better imaging and suction channel required for BAL.