Efficacy of LMA gastro airway versus endotracheal tube for therapeutic endoscopic retrograde cholangiopancreatography under general anesthesia: a randomized trial.

Objectives: LMA Gastro Airway (LGA) is an advanced airway device that allows simultaneous endoscopy and ventilation during endoscopic retrograde cholangiopancreatography (ERCP). It can be an alternative to an endotracheal tube (ETT) and hasten recovery from general anesthesia (GA). We aimed to compare LGA with ETT regarding recovery from anesthesia and adverse respiratory events.

Methods: In this randomized controlled trial, 60 adult patients undergoing ERCP under GA were included. The airway was secured with an ETT (Group A, n = 30) or LGA (Group B, n = 30). The primary outcomes were the emergence time and adverse respiratory events.

Results: LGA and ETT effectively maintained ventilation with comparable respiratory adverse events. The success rate of insertion of LGA was high (92%), and the insertion time [median (IQR)] of LGA was significantly shorter [37 s (28-56) vs 14.5 s (11-21)] (p < 0.001). The emergence [8(6.0-13.3) vs. 3 (3-5)] and total recovery time [20.5(14.75-30) vs. 12.5 (8.8-19)] was considerably shorter with LMA Gastro, with similar postoperative complications. The endoscopic satisfaction [3 (2-3) vs. 2 (1-3), p < 0.001] was better in the ETT group.

Conclusion: LGA provides faster recovery times with a similar safety profile to ETT. It is a suitable alternative to ETT for patients undergoing ERCP.

Trial registration: CTRI/2020/08/027268; Principal Investigator: Dr Anju Gupta, Date of registration: 20 August 2020.