Younger pediatric adenotonsillar surgical patients exhibit more complications at mouth gag insertion with LMA use

Wilson, Megan N.; Long, L. Stephen; Ved, Sudha A.; Harley, Earl H.

doi:10.1016/j.ijporl.2009.04.008

Cited by 6 publications

(4 citation statements)

References 5 publications

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“…Previous studies have found younger ages to present increased risk of airway complications from a general anesthesia 8,[19][20][21]25 and increased risk of laryngeal mask failure in specific procedural groups. 17,44 Our data suggest the need for heightened concern when considering laryngeal masks for younger children. On univariate analysis, smaller laryngeal mask sizes and sizes not weight-matched to manufacturer recommendations were more frequently noted to present with laryngeal mask failure (table 3).…”

Section: Discussionmentioning

confidence: 86%

“…As suggested by prior literature, anthropometric and patient history factors included sex, 12,17 age, 8,17-21 BMI, 12,19,22 smoke exposure, 12,23,24 asthma, 25,26 Failed Laryngeal Mask Airway in Pediatrics recent upper respiratory infection (URI), 7,8,20,25,27,28 gastroesophageal reflux disease, [29][30][31] obstructive sleep apnea, 19,32 congenital or acquired airway abnormalities, 27,[33][34][35][36][37][38][39][40] and history of difficult airway. 41,42 Surgical-related factors included procedure type (classified by Current Procedural Terminology code), 3,[19][20][21]43,44 surgical duration, [45][46][47] patient positioning, 48 and surgical table rotation. 12 Anesthetic factors included laryngeal mask size, 3,49 laryngeal mask size-weight <0.001 28 (3.2-258) 100.0 * As a mask ventilation was performed in 77% of patients before laryngeal mask placement for the current case, statistical analysis was performed within this subpopulation only for this variable.…”

Section: Independent Variablesmentioning

confidence: 99%

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Failure of the Laryngeal Mask Airway Unique™ and Classic™ in the Pediatric Surgical Patient

Mathis¹,

Haydar

Taylor³

et al. 2013

Anesthesiology

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Section: Discussionmentioning

confidence: 86%

Section: Independent Variablesmentioning

confidence: 99%

Failure of the Laryngeal Mask Airway Unique™ and Classic™ in the Pediatric Surgical Patient

Mathis¹,

Haydar

Taylor³

et al. 2013

Anesthesiology

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“…Some researchers reported that using LMA during adenotonsillectomy operations in children aged three years or younger is not safe and is associated with increased complications. 18 , 19 These authors suggested that more data from larger controlled studies are needed in children aged three years or younger. In our study, safe airway management was established by the use of F-LMA in 150 patient’s aged three years or younger undergoing adenoidectomy.…”

Section: Discussionmentioning

confidence: 99%

The use of flexible laryngeal mask airway for Adenoidectomies: An experience of 814 Paediatric patients

et al. 2017

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Objective:To assess flexible laryngeal mask airway (F-LMA) use during pediatric adenoidectomies in terms of patient safety, comfort, complication rates and surgeon satisfaction levels.Methods:Patients who had undergone an elective adenoidectomy after receiving general anesthesia using F-LMA from June 2012 to November 2015 were included. Patients’ demographics and the incidence of perioperative complications were investigated. The surgeon’s satisfaction level was also evaluated by questionnaire.Results:Eight hundred fourteen patient were included in the study. Conversion from F-LMA to an endotracheal tube was carried out in two patients (0.2%). Airway complications were identified in two patients. The mean duration of stay in the postoperative anesthesia care unit was 17 minutes. All patients were discharged the same day. According to the otolaryngologists F-LMA applications provide a significant reduction in the processing time (100%), postoperative patient comfort is better than when using endotracheal intubation (83.3%) and the consensus was that there should be a complete continuation of the use of the F-LMA (100%) in subsequent adenoidectomies.Conclusion:Our data show that the use of F-LMA for pediatric adenoidectomies has well tolerability profile and resulted in a lower incidence of complications. We think that the use of F-LMA for pediatric adenoidectomy is safer, simpler and speeder method.

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“…Previous studies have similarly reported increased adverse respiratory events in head and neck surgeries using a laryngeal mask. [ 15 ]…”

Section: Discussionmentioning

confidence: 99%

Ease of insertion of the laryngeal mask airway in pediatric surgical patients: Predictors of failure and outcome

Asida

Ahmed

2016

Saudi J Anaesth

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Background:Laryngeal mask airway (LMA) is an useful alternative to endotracheal tube for airway management. The risk of life-threatening adverse respiratory events during its use is rare, but we need to know about the risk-adjusted prediction of its insertion failure requiring rescue tracheal intubation and its impact on patient outcome.Materials and Methods:Five hundred patients; 6 months to 12-year-old, American Society of Anesthesiologists I and II scheduled to undergo elective surgical procedures that require general anesthesia were included in this study. LMA was inserted after induction of anesthesia. The insertion conditions, intra, and postoperative events were recorded. Our primary outcome variable was trial success from the first time.Results:We recorded 426 cases (85.2%) of first trial success with clear airway compared to 46 case (9.2%) of second trial success (P ≤ 0.001). Predictors of failure of first attempt of LMA insertion include abnormal airway anatomy (91%), body weight <16 kg and age below 5 years (44%), the use of LMA size of 1 and 1.5 (3.8%), the intraoperative lateral position (3.8%).Conclusion:The data obtained from this study support the use of the LMA as a reliable pediatric supraglottic airway device, demonstrating relatively low failure rates. Predictors of LMA failure in the pediatric surgical population should be independently considered.Trial Registration:The study is registered in the Australian and New Zealand clinical trial registry with the allocated trial number: ACTRN12614000994684. Web address of trial: http://www.ANZCTR.org.au/A CTRN12614000994684.aspx.

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Younger pediatric adenotonsillar surgical patients exhibit more complications at mouth gag insertion with LMA use

Cited by 6 publications

References 5 publications

Failure of the Laryngeal Mask Airway Unique™ and Classic™ in the Pediatric Surgical Patient

Failure of the Laryngeal Mask Airway Unique™ and Classic™ in the Pediatric Surgical Patient

The use of flexible laryngeal mask airway for Adenoidectomies: An experience of 814 Paediatric patients

Ease of insertion of the laryngeal mask airway in pediatric surgical patients: Predictors of failure and outcome

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