Is adenoidectomy in children safer with laryngeal mask airway or with tracheal intubation?

Abstract

Summary Adenoidectomy in paediatric outpatient surgery is assumed to require tracheal intubation (TT). The laryngeal mask airway (LMA) commonly used for general paediatric surgery has never been previously studied for adenoidectomy. We therefore prospectively compared in a randomized manner, the incidence of complications with TT and LMA in 56 children undergoing adenoidectomy. Preoperative, intraoperative and the lowest SPO2 values after removal of either TT or LMA were recorded. The respiratory complications, cough, stridor and/or laryngospasm, were recorded intraoperatively and after removal of the airway device. The oxygen saturation levels were significantly higher in the laryngeal mask airway group both intraoperatively and after removal of the respiratory device (P<0.05). The incidence of respiratory complications was lower in the LMA group. In conclusion we have shown that the laryngeal mask airway with a flexometallic tube is a satisfactory alternative to tracheal intubation for outpatient paediatric adenoidectomy.

Surgeons' exposure to sevoflurane during paediatric adenoidectomy: a comparison of three airway devices

“…There were no surgical complications and anaesthetic adverse events were comparable in all three groups. This is consistent with previous studies in which laryngeal masks, cuffed tracheal tubes and uncuffed tracheal tubes were all safely used during paediatric adenoidectomy . Most of our anaesthetic complications coincided with high sevoflurane concentrations and may have been due to manipulation of the McIvor mouth gag, resulting in displacement of the airway device.…”