Document Detail


Use of laryngeal mask airway in pediatric adenotonsillectomy.
MedLine Citation:
PMID:  21242545     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: To compare the use of flexible laryngeal mask airway (LMA) and endotracheal tube (ETT) in pediatric adenotonsillectomy.
DESIGN: Prospective randomized trial.
SETTING: Tertiary care hospital.
PATIENTS: One hundred thirty-one children (aged 2-12 years). Exclusion criteria were body mass index (calculated as the weight in kilograms divided by the height in meters squared) greater than 35 and craniofacial anomalies. Obstructive sleep apnea was the most common indication for surgery.
INTERVENTION: Children undergoing adenotonsillectomy were randomized to use of an LMA or ETT. A standardized anesthesia protocol was used.
MAIN OUTCOME MEASURES: Primary outcome measure was laryngospasm. Secondary measures included anesthesia, operative, and recovery times.
RESULTS: Sixty children were randomized to the LMA group and 71 to the ETT group. There was no difference between groups with regard to age (P = .76), ethnicity (P = .75), body mass index (P = .99), or American Society of Anesthesiologists grade (P = .46). Incidence of postoperative laryngospasm between LMA (12.5%) and ETT (9.6%) was similar (P = .77). In 10 patients, the LMA was changed to ETT intraoperatively owing to tube kinking or difficulty with visualization. Mean (SD) surgical times for LMA and ETT groups were 33.35 (13.39) and 37.76 (18.26) minutes, respectively (P = .15). Time from surgery end to extubation was significantly shorter in patients who used LMA (P = .01) by 4.06 minutes. There were no differences (P = .49) in postanesthesia care unit recovery times.
CONCLUSIONS: An LMA is an efficient alternative to ETT in pediatric adenotonsillectomy. When comparing LMA and ETT, there is no difference in rates of laryngospasm. Time to extubation is significantly shorter in patients using LMA. Before adopting the routine use of LMA in pediatric adenotonsillectomy, further study is needed to address visualization and kinking issues associated with this device.
Authors:
Angela Peng; Kelley M Dodson; Leroy R Thacker; Jeannette Kierce; Jay Shapiro; Cristina M Baldassari
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of otolaryngology--head & neck surgery     Volume:  137     ISSN:  1538-361X     ISO Abbreviation:  Arch. Otolaryngol. Head Neck Surg.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8603209     Medline TA:  Arch Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  42-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Otolaryngology, Eastern Virginia Medical School, Children's Hospital of the King's Daughters, 601 Children's Ln, Norfolk, VA 23507. baldassc@yahoo.com; cristina.baldassari@chkd.org.
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