Flexible Fibreoptic Bronchoscopy Performed Through a Laryngeal Mask Airway (FFB-LMA) in a Paediatric Population: Experience of a Tertiary Care Children's Hospital in Sri Lanka

Abstract

Studies suggest that flexible fibreoptic bronchoscopy, when performed through a laryngeal mask airway (FFB-LMA), have fewer rates of complications and better efficacy. In comparison to rigid bronchoscopy, FFB is safer for the operator, as it prevents direct exposure to respiratory tract infections such as Covid-19. Airway maintenance with LMA is uncommon when performing FFB in Sri Lanka. This study aimed to report the efficacy and peri-procedural complications of FFB performed through LMA at a tertiary care children's hospital in Sri Lanka. Data were retrieved retrospectively from anaesthetic charts and bed head tickets of all the patients who underwent FFBs performed through LMA at the Sirimavo Bandaranayake Specialized Children's Hospital, Peradeniya. Collected data included age, gender, indication, duration of the procedure, bronchoscopy findings, and complications, if any. Of the total of 176 patients, the majority were infants and between 1-5 years (33.52% each). The most common indication was recurrent/persistent respiratory tract infections (57.9%) followed by foreign body aspirations (21.6%). Clinically significant abnormalities were detected in 87% of the cases. The success rate of extraction of positively identified foreign bodies was 100%. Perioperative complications were observed in 4.5% of the patients. Risk factor analysis, based on multivariate logistic regression, identified the duration of the procedure as a risk factor for complications (OR = 15.57, p = 0.0011). FFB performed through LMA has good efficacy and low complication profile in the studied patient sample.