• Enzo Zamparelli, Alfonso Fiorelli, Giuseppe La Cerra, Carmine Guarino, Elena Santoriello, Salvatore Buono, Antonio Corcione, and Marco Rispoli.
• Unit of Anesthesiology and Intensive Care, Vincenzo Monaldi Hospital, Naples, Italy - enzozamparelli@gmail.com.
• Minerva Anestesiol. 2019 Jul 1; 85 (7): 756-762.

BackgroundThe aim of this study was to evaluate the use of laryngeal mask airway (LMA)® Protector™ by comparison with traditional LMA for performing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).MethodsThis was a retrospective observational single-center study including 143 patients who underwent EBUS-TBNA for mediastinal staging of lung cancer. Patients were retrospectively divided into two groups based on whether a traditional LMA (traditional LMA group) or LMA Protector was used. Anesthesiologist outcomes, diagnostic yield of EBUS-TBNA, and complications related to the procedure were computed for each group and statistically compared.ResultsLMA traditional group and LMA Protector group counted 70 and 73 patients, respectively. LMA traditional group versus LMA Protector group showed no significant difference on time of LMA insertion (120±25 vs. 118±39 s; P=0.49), reposition rates (18% vs. 16%; P=0.78); systolic pressure (140±55 vs. 118±37 mmHg; P=0.59); diastolic pressure (82±15 vs. 90±26 mmHg; P=0.39); heart rate (82±9.9 vs. 83±20 bpm; P=0.49); SpO2 values (93±21% vs. 92±14%; P=0.63); diagnostic accuracy (91.3% vs. 92%; P=0.95), and patients' complications as nausea (4% vs. 3%; P=0.61); vomiting (3% vs. 1%, P=0.96); gastric aspiration (7% vs. 1%; P=0.08); and sore throat (7% vs. 3%; P=0.22). Conversely, LMA traditional group versus LMA Protector group presented a longer procedural time (47±23 vs. 38±17 s; P=0.02), higher number of passage to biopsy target lesion (4±0.5 vs. 3.1±0.6; P=0.01); higher rate of balloon ultrasound rupture (11% vs. 1%; P=0.01).ConclusionsEBUS-TBNA conducted with LMA Protector is a useful strategy that reduced the procedural time and in theory ensured the comfort of patients. Our results should be confirmed by larger, prospective, randomized studies.

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