A randomised comparison of the single use LMA Flexible^™ with the reusable LMA Flexible^™ in paediatric dental day‐case patients

Abstract

SummaryIn this study we compared the performance of the single use flexible laryngeal mask airway (LMA Flexible™) with the original reusable LMA Flexible™ in paediatric dento‐alveolar day‐case surgery. The aim of the study was to determine whether these two supraglottic airway devices were clinically equivalent when used for simple dental extractions in children under general anaesthesia. This randomised comparative trial in 100 healthy children used first attempt airway insertion success as its primary outcome measure. Secondary outcomes included the adequacy of ventilation, incidence of airway obstruction and the requirement for device manipulation and the incidence of adverse airway outcomes during recovery from anaesthesia. No difference was found between the devices in first attempt insertion success rate (94% with reusable LMA Flexible and 90% with single use LMA Flexible, p = 0.358), and ease of insertion was also similar (p = 0.5). Both devices performed equally well during surgery, with no significant differences in episodes of intra‐operative airway compromise (p = 0.387), and both the single use and reusable LMA Flexible displayed excellent recovery characteristics, with no occurrences of emergence airway obstruction. No blood was discovered within the inner LMA tube shaft in either device, implying that both protected against tracheobronchial soiling. We conclude therefore that the single use LMA Flexible is an acceptable alternative to the reusable LMA Flexible.

Anesthetic management of a child with Langer-Giedion (TRPS II) syndrome

“…These anomalies may infl uence the mode of induction and airway establishment; so that diffi cult airway plans should be made. For short procedures, a fl exible laryngeal mask airway (FLMA) may be an appropriate airway option [11]. There may be some arguments against the use of a laryngeal mask in dental anesthesia-risk of malposition, obstruction, or aspiration-but many authors support its insertion in these procedures [11,12].…”

“…For short procedures, a fl exible laryngeal mask airway (FLMA) may be an appropriate airway option [11]. There may be some arguments against the use of a laryngeal mask in dental anesthesia-risk of malposition, obstruction, or aspiration-but many authors support its insertion in these procedures [11,12]. We have had experience with laryngeal masks in more than 1100 pediatric dental patients, without any serious complications and with a high satisfaction rate on the side of dental surgeons.…”

Extraglottic airway devices: A review

“…Both devices are equally easy to insert, with first attempt insertion success rates being comparable to those reported for the cLMA. [23] Due to the flexible nature of the airway tube, insertion may be more challenging and the use of a stylet or introducer has been suggested as a means to overcome this limitation. [24] Increased occurrence of airway trauma from introducer devices have not been reported despite the concern.…”

Ventilation via Cut Nasotracheal Tube During General Anesthesia

“…We prefer to use laryngeal mask airways only for cavity preparation, wherein it is not necessary to administer muscle relaxants and perform laryngoscopy. Dental treatment can be performed using a flexible laryngeal mask airway (FLMA) 8 ; however, its flexible tube sometimes interferes with dental procedures that need to be performed with precision, particularly those involving proper occlusion of the teeth. It is difficult to master the technique of using FLMA as a nasal airway.…”