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Removal of the laryngeal tube in children: anaesthetized compared with awake

J Lee1, J Kim, S Kim

  • 1Department of Anesthesiology, Seoul National University College of Medicine, Seoul, Korea.

British Journal of Anaesthesia
|April 10, 2007
PubMed

Insights

Removing the laryngeal tube (LT) while children are anesthetized reduces adverse respiratory events like cough and hypoxia compared to awake removal. However, airway obstruction is more common during anesthesia and manageable with chin-lift maneuvers.

Area of Science:

  • Pediatric Anesthesiology
  • Airway Management

Background:

  • Laryngeal tube (LT) is a common pediatric airway device.
  • Evidence comparing LT removal in anesthetized versus awake states is lacking.

Purpose of the Study:

  • To compare the incidence of respiratory adverse events after laryngeal tube removal in children under anesthesia versus awake states.

Main Methods:

  • Seventy healthy children (1-12 years) were randomized into two groups: LT removal under anesthesia (Group A) or upon awakening (Group B).
  • Respiratory adverse events were recorded within 1 minute of LT removal.

Main Results:

  • Awake removal (Group B) showed significantly higher rates of cough, hypersalivation, desaturation, and LT dislocation.
  • Anesthetized removal (Group A) had a higher incidence of upper airway obstruction, easily managed with chin/jaw lifting.

Conclusions:

  • Laryngeal tube removal in the anesthetized state is associated with fewer adverse events, including cough, hypersalivation, and hypoxia.
  • Upper airway obstruction during anesthetized removal is predictable and manageable, making it a potentially safer approach.
Abstract

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