Removal of LMA in children.

Parry, M G; Glaisyer, Hilary; Bailey, Paul

doi:10.1093/bja/78.3.337

Cited by 21 publications

(11 citation statements)

References 6 publications

(7 reference statements)

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“…Most previous studies included participants form less than 1 year to more than 13 years of age [2][3][4][5][6][7]11,12]. The airway reflex may be affected by growth, as children have a more irritable airway than adults [14].…”

Section: Discussionmentioning

confidence: 99%

“…Further studies are needed in children with reactive airway disease and/or RTI. Finally, it is unclear whether it is beneficial to remove the LMA while anesthetized during dental or otolaryngologic surgeries that directly involve the airway [6,7]. Since this type of surgery itself may irritate the upper airway or increase secretions, rapid return of the airway reflexes may be critical in this context.…”

Section: Discussionmentioning

confidence: 99%

“…In adults, it is generally recommended that the LMA be removed when patients become fully awake [1]. However, in pediatric patients, diverse recommendations have been suggested [2][3][4][5][6][7]. Several factors such as varying depths of anesthesia, different volatile agents, or a wide range in the age of study participants, make it difficult to reach consensus regarding LMA removal during an adequate plane of anesthesia.…”

Section: Introductionmentioning

confidence: 99%

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A randomized controlled trial comparing Laryngeal Mask Airway removal during adequate anesthesia and after awakening in children aged 2 to 6 years

Park

Kim

et al. 2012

Journal of Clinical Anesthesia

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A randomized controlled trial comparing Laryngeal Mask Airway removal during adequate anesthesia and after awakening in children aged 2 to 6 years

Park

Kim

et al. 2012

Journal of Clinical Anesthesia

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“…4 However, both Kitching and Samarkandi suggest that there is no difference in the incidence of complications whether the LMA is removed awake or anesthetized, 5,6 while Parry on the other hand recommends that the LMA should be left in situ until it is expelled spontaneously by the awake child. 7 The use of the LMA in pediatric anesthesia is increasing. However, there is little published work on the use of the size #1 LMA.…”

Section: Discussionmentioning

confidence: 99%

Airway complications in infants: comparison of laryngeal mask airway and the facemask-oral airway

Harnett

Kinirons

Heffernan

et al. 2000

Can J Anesth/J Can Anesth

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Purpose: To compare the incidence of airway complications in children less than one year of age whose airways were maintained during anesthesia with either a laryngeal mask airway (LMA) or a facemask and oral airway (FM-OA). Methods:We randomized 49 -ASA class 1&2 -infants to an LMA or FM-OA group. All infants were undergoing minor general, urological or orthopedic procedures. Anesthesia was induced and maintained with halothane in nitrous oxide 50% and oxygen. The airway was removed in both groups when the infant was awake. The occurrence of airway complications (breath-holding, coughing, laryngospasm, secretions, obstruction and oxygen saturation < 95%) at induction of anesthesia, intraoperatively and during emergence from anesthesia was recorded.Results: Airway complications occurred perioperaively in 15 of 27 infants in the LMA group and in 5 of 22 infants in the FM-OA group (P :0.02). Conclusion:In infants, the use of the LMA is associated with an increased incidence of airway complications compared with the use of the FM-OA.Objectif : Comparer l'incidence de complications de la canulation chez des enfants de moins d'un an dont l'accès aux voies aériennes a été maintenu pendant l'anesthésie, soit avec un masque laryngé (ML), soit avec un masque et une canule orale (M-CO).Méthode : Nous avons réparti 49 enfants -ASA I et II -en groupes ML ou M-CO. Tous les enfants devaient subir une intervention mineure, urologique ou orthopédique. L'anesthésie a été induite et maintenue avec de l'halothane dans un mélange à 50 % de protoxyde d'azote et d'oxygène. La canule a été retirée chez tous les enfants à leur réveil. On a noté l'occurrence de complications de la canulation (arrêt de la respiration, toux, laryngospasme, sécrétions, obstruction et saturation en oxygène < 95%) lors de l'induction de l'anesthésie, pendant l'opération et pendant la récupération de l'anesthésie.Résultats : Les complications peropératoires de la canulation sont survenues chez 15 des 27 enfants du groupe ML et chez 5 des 22 enfants du groupe M-CO (P : 0,02).Conclusion : Chez les enfants, l'usage du ML, comparé à celui d'un masque et d'une canule orale, est associé à une incidence accrue de complications de la canulation.

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“…A LMA is useful in the recovery phase since it can be left in place until the patient's reflexes return, whereas an endotracheal tube raises the dilemma of extubation at a deep plane of anaesthesia versus awake extubation. 5 The pros and cons of using a LMA are listed in Table 3. Attention has to be given to careful insertion of the operative mouth gag in either technique, ensuring that the airway device remains unobstructed.…”

Section: Adenotonsillectomymentioning

confidence: 99%

Anaesthesia for elective ear, nose and throat surgery in children

Singh¹,

Whyte²

2009

Anaesthesia & Intensive Care Medicine

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this review outlines anaesthetic considerations for commonly performed elective ear, nose and throat procedures, which constitute a major portion of the paediatric anaesthesia workload. Most routine surgery can be performed on a daycare basis, but careful preoperative assessment is vital to identify those patients who are unsuitable for daycare surgery owing to complications of their presenting illness (e.g. obstructive sleep apnoea; Osa) or other co-morbidities. children undergoing middle ear surgery need special attention to prevent bleeding, hypothermia and postoperative nausea and vomiting (PONV). adenotonsillectomy is most commonly performed to relieve the symptoms of Osa. the main anaesthetic concerns are analgesia, PONV, risk of postoperative haemorrhage and postoperative disposition. daycare tonsillectomy involves careful patient selection and good communication with families regarding the postoperative phase and potential complications. Use of lasers is common in airway surgery; associated risks include airway fire and injury to the eyes of the patient and theatre staff.

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Removal of LMA in children.

Cited by 21 publications

References 6 publications

A randomized controlled trial comparing Laryngeal Mask Airway removal during adequate anesthesia and after awakening in children aged 2 to 6 years

A randomized controlled trial comparing Laryngeal Mask Airway removal during adequate anesthesia and after awakening in children aged 2 to 6 years

Airway complications in infants: comparison of laryngeal mask airway and the facemask-oral airway

Anaesthesia for elective ear, nose and throat surgery in children

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