So sánh hiệu quả thông khí giữa mask thanh quản dạ dày và nội khí quản trong thủ thuật nội soi mật tụy ngược dòng

Endoscopic Retrograde Cholangiopancreatography (ERCP) is an indispensable procedure for diagnosing and treating a range of biliary and pancreatic pathologies. Historically, airway management during ERCP, often performed under intravenous anesthesia, presented significant risks of respiratory complications, including severe respiratory failure. The continuous evolution of medical technology has led to the development of advanced airway devices, such as the laryngeal gastric mask airway, designed to optimize ventilation control during endoscopic procedures without requiring muscle relaxants. Despite these advancements, there is a recognized paucity of comparative research in the Vietnamese context regarding the ventilation efficacy of these novel devices. This study addresses this critical gap by comparing the effectiveness of the laryngeal gastric mask airway with traditional endotracheal intubation for ensuring optimal ventilation efficacy during ERCP.

Anesthesiologists, gastroenterologists, critical care physicians, and researchers involved in airway management during endoscopic procedures.

This randomized controlled trial rigorously compared the ventilation efficacy of the laryngeal gastric mask airway (LMA Gastro) against endotracheal intubation in 60 patients undergoing Endoscopic Retrograde Cholangiopancreatography (ERCP). The primary objective was to assess crucial ventilation parameters, including airway insertion time, tidal volume, air leakage, peak airway pressure (Ppeak), and oxygen saturation (SpO2), at various critical stages of the procedure. The findings reveal that the laryngeal gastric mask airway offers a notable advantage with a significantly faster insertion time (25.47 ± 5.05 seconds) compared to endotracheal intubation (48.53 ± 7.21 seconds, p < 0.01). Furthermore, both airway management techniques demonstrated comparable and adequate ventilation efficacy, maintaining SpO2, end-tidal CO2 (EtCO2), and tidal volume within normal physiological limits, with air leakage rates consistently below 10%. Importantly, the LMA Gastro group exhibited a significantly lower peak airway pressure (p < 0.05), suggesting a potentially gentler and safer ventilation profile. This study concludes that the laryngeal gastric mask airway is a suitable and superior alternative to endotracheal intubation, providing effective ventilation while offering benefits in procedural speed and reduced airway pressures during ERCP. These results have significant implications for optimizing airway management protocols, potentially enhancing patient safety and procedural efficiency in ERCP settings.