Laryngeal mask cuff inflation at removal does not affect early postoperative laryngopharyngeal morbidity

We assessed the effect of cuff inflation of the laryngeal mask airway at removal on sore throat, pharyngeal morbidity and airway complications.

In a prospective randomized trial, we used a standardized technique of anesthesia and of laryngeal mask insertion in 126 consecutive day-case patients. Postoperatively, on eye opening, the masks were removed either inflated (Group A) or deflated (Group B) and examined for blood by a blinded observer. Episodes of coughing, gagging, laryngospasm, hiccups and retching, and symptoms of sore throat and hoarseness were recorded by the same observer.

Demographics were similar. Bloodstaining occurred in 21% of patients in Group A (n = 63) vs 13% in Group B (n = 63; P = 0.23); the incidence of sore throat was identical (19%). Group A experienced more hoarseness (22% vs 9%; P = 0.05). Overall airway complications did not differ between groups (19% vs 11%; P = 0.21).

We conclude that removal of the laryngeal mask airway inflated does not reduce the incidence of sore throat, pharyngeal morbidity or airway complications.