Use of Laryngeal Mask Airway in Pediatric Adenotonsillectomy

Abstract

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.

The Flexible Laryngeal Mask Airway in Pediatric Patients Undergoing Adenotonsillectomy

“…The extubation time was measured and there was a difference of 4minutes and 41 seconds and it was found to be statistically significant. This is similar to the observation by A Peng et al [8] where they compared the extubation time among paediatric adenotonsillectomies and observed a significantly shorter time 4.06 minutes for patients where FLMA was used as the airway device. None of the patients in our study had an incidence of laryngospam, bronchospam and vomiting on placement of the airway device.…”

“…When FLMA is in place, it completely covers the glottis and hence doesn't allow any soiling of the airway. The use of FLMA decreases the requirement of muscle relaxation and hence ensures speedy discharges [8]. Decreased incidence of cough and laryngospasm are other major benefits of LMA [9][10][11][12][13].…”

“…Peng A et al [8] observed the surgical exposure in adenotonsillectomy while using FLMA and found that it provided adequate surgical access in 93.8% of patients. Aziz L [18] also had reported adequate surgical access where FLMA was used.…”

“…This could be due to the surgical position of the hyperextended neck for adenotonsillectomy which keeps the oropharynx at a lower level than the glottis thereby preventing the trickling of blood into the trachea and the surgical technique of our surgeon. Amongst various studies evaluating blood staining of the airway device, the study by A Peng [8] performed a flexible fiberoptic bronchoscopy through the FLMA at the conclusion of adenotonsillectomy and blood was noted in the laryngeal inlet in only 1 case. Our study had certain limitations.…”

Efficacy of premedication with intranasal dexmedetomidine on inhalational induction and postoperative emergence agitation in pediatric undergoing cataract surgery with sevoflurane

“…Cataract surgery is one of the short-term procedures with minimal stress; thus, anesthesia maintained by inhaling sevoflurane with spontaneous ventilation through LMA can dramatically shorten the extubation time [17]. Furthermore, sevoflurane is recommended for inhalational induction because of the favorable smell without irritating upper respiratory tract [18], and 1-1.3 MAC of sevoflurane can provide sufficient anesthesia depth without associating severe respiratory depression [19].…”