Use of laryngeal mask airway in children with upper respiratory tract infection, compared with face mask: Randomized, single blind, clinical trial

Abstract

In children with uncomplicated URI, the administration of inhalation anesthetics in general anesthesia by LMA is likely to cause fewer adverse events than the use of FM.

Is Corticosteroid of No Use for Pediatric Patients with Common Cold Undergoing Anesthesia? A Randomized, Double-Blind, Clinical Trial

“…The inclusion criteria for pediatric patients were as follows: (1) age range of 1 - 6 years; (2) parents’ recognition of mild URI symptoms (eg, cough, sneeze, and nasal discharge or congestion), initiated within the past 2 weeks; (3) no evidence of the symptoms of bacterial (eg, ill appearance evaluated by the anesthesiologist, axillary temperature > 38°C, and purulent discharge or sputum) or lower respiratory tract infection (eg, crackles or wheezing sounds); and (4) any other medical condition (eg, respiratory conditions, cardiac diseases, allergies, conditions resulting in difficult airway management, and neurological disorders). All the patients had to be anesthetized for the ophthalmologic examination in a short period of time (less than 6 weeks) to prevent any deleterious outcomes ( 6 , 7 ).…”

“…URI was diagnosed based on a positive history of nasal congestion or discharge, initiated 2 weeks prior to surgery, as mentioned by the parents or guardians ( 6 , 7 ). On the day of surgery, preanesthesia symptoms of common cold (eg, runny nose, nasal congestion, cough, sputum, and sneeze) were evaluated by an anesthesiologist (appendix 1 in the supplementary file) ( 6 , 7 ). Patients who scored above 2 on any of the items in the questionnaire were considered to have moderate to severe URI and were not enrolled in the study.…”

“…Based on previous studies, coughing, given its higher incidence among adverse respiratory events, was measured as the primary outcome through direct observation during recovery and a telephone call on the first postoperative day (appendix 2 in the supplementary file) ( 6 , 7 ).…”

“…The secondary outcomes were as follows (appendix 2 in the supplementary file): (1) bronchospasm, assessed by the anesthesiologist and characterized by inspiratory/expiratory wheezing sounds ( 6 , 7 ); (2) apnea characterized by the absence of air flow for more than 10 seconds through the airway without any respiratory effort ( 6 , 7 ); and (3) laryngospasm (partial) indicated by stridor sounds for more than 10 seconds ( 6 , 7 ). Furthermore, desaturation and vomiting were scored and evaluated ( 6 , 7 ). Any cardiovascular events or 7-day readmission due to respiratory problems were reported ( 6 , 7 ).…”

“…Many studies have been performed to reduce the risk of these complications among patients. Utilization of laryngeal mask airways (LMAs), instead of endotracheal tubes, or lidocaine administration (intravenous or topical administration on LMA) has shown significant improvements in the outcomes, while in pediatric patients without upper respiratory tract infections (URIs), the results have not been promising ( 4 - 6 ). Also, different anesthetic methods and medications have been continuously investigated to reduce the risks as much as possible ( 4 ).…”