Background and Aims: Upper gastrointestinal (GI) endoscopic procedures under total intravenous anaesthesia (TIVA) pose risks of sedation-related complications. This study compared the first-attempt endoscope insertion success between the Laryngeal Mask Airway ® (LMA) Gastro™ and low-flow nasal cannula during upper GI endoscopy under TIVA. Methods: This prospective randomised controlled study involved 140 adult patients scheduled for upper GI endoscopy under TIVA. The participants were randomly assigned into two groups: Group L (LMA ® Gastro™) and Group C (low-flow nasal cannula). In Group L, LMA ® Gastro™ was inserted, and in Group C, oxygen was supplemented using a low-flow nasal cannula at 4 litres/min. The primary outcome was first-attempt success of endoscope insertion. Secondary outcomes included endoscope insertion time, endoscopist and anaesthesiologist satisfaction scores, and intra- and postoperative complications. Data were analysed using statistical package for social sciences (SPSS) 19.0, and P < 0.05 was considered statistically significant. Results: The first-attempt success rate for endoscope insertion was comparable between the groups (Group L: 92.6% vs. Group C: 95.7%, P = 0.44). However, the endoscopy insertion time was significantly prolonged in Group L (Median interquartile range (seconds): 30 22-41 vs. 17.5 13-22, P < 0.001). Anaesthesiologist satisfaction was comparable between the groups, but endoscopists were more satisfied with Group C ( P < 0.001). Group L had significantly fewer intraoperative respiratory adverse events compared with Group C; however, a higher incidence of postoperative sore throat was observed in Group L (20.5%). Conclusion: The first-attempt endoscope insertion success rate was comparable between the LMA ® Gastro™ and nasal cannula groups in patients undergoing upper GI endoscopy under TIVA.
Selvin et al. (2026) studied this question.