Effect of Laryngeal Mask Airway on Image Quality in Pediatric Patients Undergoing Brain Magnetic Resonance Imaging: A Randomized Controlled Trial

Abstract

Background: Magnetic resonance imaging (MRI) is highly sensitive to motion, resulting in artifacts and lowering image quality. Laryngeal mask airway (LMA) provides numerous advantages over endotracheal tubes as it reduces laryngospasm, coughing, and the risk of postoperative desaturation. Objectives: We aimed to compare LMA with oral airway for airway management during brain MRI in terms of reducing motion artifacts, which can improve image quality. Methods: This randomized, controlled, double-blind trial was carried out on 40 pediatrics aged 1 - 18 years, American Society of Anesthesiologists (ASA) physical status І and П undergoing brain MRI. Patients were randomized into two equal groups according to the airway method, the control (Guedel oral airway) group and the LMA group. A compatible anesthesia machine was used to provide O2 and sevoflurane 2% - 4%. Results: The mean MRI image quality score was significantly higher in the LMA group than in the control group (26.10 ± 3.97 versus 18.60 ± 5.30, P < 0.001). Mean arterial blood pressure and heart rate were significantly lower in the LMA group than in the control group at all study times except at baseline and immediate post-extubation (P < 0.05). Cough was significantly lower in LMA than in the control group (15% vs. 50%, P = 0.040). Airway complications (sore throat, laryngeal spasm, and bronchospasm), nausea, and vomiting did not have a significantly different between the two groups. Conclusions: Compared to Guedel oral airway, using LMA for airway management in pediatrics undergoing MRI scans improved the image quality with less cough and better hemodynamics.

Supraglottic airway devices: a powerful strategy in airway management

“…However, a randomized controlled trial showed a higher likelihood of vocal cord injury when using I-gel compared to air-Q [93]. From a clinical point of view, SAD can be an option for airway maintenance in high-risk pediatric patients during anesthesia [94,95].…”