Effect of LMA®GastroTM airway for Intraoperative Transesophageal Echocardiography.

Background: This study aimed to explore the effect of the LMA®Gastro^TM airway (Teleflex Medical, Athlone, Ireland) for intraoperative TEE.

Methods: This randomized controlled trial enrolled patients undergoing transurethral prostatectomy between April 2023 and May 2024 at the authors' Hospital. The participants were randomly assigned to the endotracheal tube intubation (ETT) or LMA®Gastro^TM groups. The primary outcome was the time taken for TEE probe insertion. The secondary outcomes included the initial success rate of TEE probe insertion, the number of TEE probe insertion attempts, the number of patients with blood on the airway equipment, postoperative symptoms, and symptoms at discharge.

Results: A total of 97 patients were enrolled, with 49 (mean age 68.3 ± 6.0 years) receiving laryngeal mask airway placement and 48 (mean age 67.5 ± 6.8 years) receiving endotracheal intubation. The time for TEE probe insertion was shorter in the LMA®Gastro^TM group than in the ETT group (24.4 ± 6.8 vs. 34.3 ± 8.5 seconds, P = 0.001; 95% confidence interval of the difference: -13.0 to -6.8 seconds). The initial success rate of TEE probe insertion in the LMA®Gastro^TM group was higher than in the ETT group. There were similar rates of blood on the airway device upon removal between the two groups.

Conclusion: In patients undergoing transurethral prostatectomy, the LMA®Gastro™ Airway resulted in shorter TEE probe insertion time and a higher initial success rate for TEE probe placement compared with ETT. It also reduced the incidence of postoperative throat pain in patients. The finding indicated promising application of LMA®Gastro™ Airway in operations requiring TEE.