Safety Evaluation of the Laryngeal Mask Airway in Pediatric Laparoscopic Hernia Surgery.

OBJECTIVE

The aim of this study was to evaluate the intraoperative safety of the laryngeal mask airway (LMA) in pediatric laparoscopic surgery by assessing regurgitation and aspiration events.

METHODS

This study included 220 pediatric patients aged 1 to 6 years, weighing 9 to 30 kg, with an American Society of Anesthesiologists physical status I or II, scheduled for elective laparoscopic high ligation of the hernia sac under general anesthesia. Quantitative ultrasonographic assessment of the gastric antrum was performed preoperatively to evaluate gastric emptying. Following the procedure, LMA removal was conducted after the return of spontaneous regular respiration. Salivary pH values were measured at the ventilatory surface of the laryngeal side, the surrounding area of the laryngeal side, and the lingual surface of the LMA using precision pH test strips to detect intraoperative regurgitation or aspiration.

RESULTS

Two patients were excluded due to qualitative ultrasonographic findings indicating a high risk of aspiration, leading to the postponement of surgery. Among the remaining 218 patients, suspected regurgitation was noted in 41 cases (18.8%) and suspected aspiration in 24 cases (11.0%). No confirmed cases of regurgitation or aspiration were identified.

CONCLUSIONS

With adherence to strict preoperative fasting protocols and appropriate patient selection, the use of LMA in pediatric patients undergoing laparoscopic high ligation of the hernia sac appears to be a feasible and safe method of airway management.