Novel Use of a Nasal Pharyngeal Airway during Shared Airway Deep Sedation Procedures: A Case Series report.
Ravi Piryani,Christopher Heard, Jonathan Malinovsky.
Department of Anesthesiology, University @ Buffalo.

INTRODUCTION

We routinely provide deep sedation using midazolam, fentanyl and propofol infusion for office based pediatric dental procedures. This involves a non-instrumented airway with supplemental oxygen via nasal cannula. As is expected with deep sedation, there is often depression of airway reflexes that may require the need for airway intervention (1). When sharing the airway with the dentist it sometimes becomes difficult, if not impossible to maintain a patent airway with formal airway instrumentation for the procedure. This then requires a deepen plane of sedation, akin to general anesthesia as well as more specialized equipment.  We do provide general anesthesia with a LMA in certain cases using a customized 3D printed LMA-Prop that we designed and printed. Using an earlier version of this LMA-Prop, we have utilized a nasal pharyngeal airway (NPA) as a laterally placed oral airway held in position using this LMA-Prop. This case report briefly describes the details of these 3 cases.