Removal of the laryngeal mask airway in children: deep anesthesia versus awake.

STUDY

OBJECTIVE

To compare the incidence of adverse airway events identified with removal of the laryngeal mask airway (LMA) from an awake child or from a child before his or her airway reflexes had returned.

DESIGN

Prospective, randomized study.

SETTING

University-affiliated children's hospital.

PATIENTS: 333 ASA physical status I and II patients ages 1.5 to 15 years undergoing elective surgery.

INTERVENTIONS: At the time of removal of the LMA at the end of surgery, patients were anesthetized or had intact airway reflexes.

MEASUREMENTS AND MAIN

RESULTS

Any airway problems occurring within 15 minutes of LMA removal were recorded. These problems included airway obstruction (laryngeal spasm and biting of the LMA), peripheral hemoglobin oxygen saturation less than 90%, stridor requiring manipulation of the airway, vomiting, retching, and excessive salivation. Airway problems occurred after LMA removal among 23 children who had their LMA removed prior to return of airway reflexes, and among 13 subjects who had their LMA removed after the return of airway reflexes.

CONCLUSION

Removal of the LMA during anesthesia and after return of airway reflexes results in a similar incidence of airway problems in children.