Efficacy of the laryngeal mask airway gastro during trans-esophageal echocardiography in pediatrics: A randomized trial

Laryngeal mask airway gastro (LG) is a dual channel laryngeal mask airway. It has an endoscopy channel to facilitate esophageal intubation and a separate channel with terminal cuff for lung ventilation. It provides secure unobstructed airway and adequate seal for positive pressure ventilation. We evaluated the LG efficacy and feasibility compared to endotracheal tube (ETT) in pediatric trans-esophageal echocardiography (TEE). The study was registered at Pan African Clinical Trials (No: PACTR202008749509618). The study included 154 pediatric patients, weighed ≥ 30 kg with non-cyanotic heart disease. Patients were assigned to ETT or LG groups. TEE insertion success rate was our primary outcome. TEE insertion success rate at the first attempt, number of attempts and ease of insertion of LG, cardiologist's satisfaction, extubation and recovery time, and complications were secondary outcomes. The success rate of TEE insertion was 95.8% (80.6% at first attempt) in ETT group and was 98.6% (90.5% at first attempt) in LG group. LG insertion success rate was 96.1% (95.9% at first attempt) and ease of insertion was reported in 91.9% of patients. Short extubation time and early recovery in LG group with significant difference between groups (P = 0.003 and 0.009, respectively). Cardiologist's satisfaction was higher in LG group (P = 0.006). Complications were lower in LG group with insignificant difference between t groups (P = 0.244). The LG proved a suitable substitute for ETT in pediatric TEE. It is easy, and effective for securing the airway. It gains high cardiologist's satisfaction and provides early less eventful recovery of patients.