Appropriate laryngeal mask airway size for overweight and underweight children

Abstract

SummaryThe aim of this study was to compare conventional laryngeal mask airway sizing by weight with sizing by age in over‐ or underweight children. We studied 26 overweight (body mass index > 85th centile) and 26 underweight (body mass index < 15th centile) children. After general anaesthesia was induced, laryngeal mask airways sized by the patient’s weight and by an ideal weight (estimated from the patient’s age according to standardised tables) were inserted consecutively. In overweight children, oropharyngeal leak pressure was significantly greater when the laryngeal mask was sized by the patient’s actual weight. On the other hand in underweight children, it was significantly greater when sized by the ideal weight. In conclusion, laryngeal mask airway sizing according to the manufacturer’s weight‐based recommendation is to be preferred in overweight children, but laryngeal mask airway size by an ideal weight estimated from the patient’s age is a better choice in underweight children.

A clinical trial evaluating the laryngeal mask airway-Supreme in obese children during general anesthesia

“…Appropriate LMA size selection is very important for obese children to ensure adequate intraoperative ventilation. Kim et al [27] found that though development of oropharyngeal cavity is mainly related to age, a higher oropharyngeal leak pressure can be obtained if body weight is used when selecting the double-lumen LMA for obese children, thus making ventilation safer and more effective. In the current study, the body weight of the children ranged from 33 to 50 kg; therefore we used the size-3 LMA-Supreme.…”

Failure of the Laryngeal Mask Airway Unique™ and Classic™ in the Pediatric Surgical Patient

“…matching, 45,50,51 anesthesia caregiver experience, 16,52 and current intraoperative difficult mask ventilation (if performed before laryngeal mask placement). 12 To adjust for unmeasured confounders related to procedure or patient complexity, admission status was also studied.…”

Optimal Flexible Laryngeal Mask Airway Size in Children Weighing 10 to 20 kg

“…Our findings may, therefore, not apply to children with abnormal upper airways or poor lung compliance. Second, the children were within the normal weight range for the 22-to 84-monthold paediatric population, so our findings may not apply to overweight or underweight children, as described by Kim et al 18 . Third, we confined our study to FLMAs.…”