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Reinforced Laryngeal Mask in Pediatric Laparoscopic Surgery
Xiao-Li Sun1, Jie Li1, Zhen-Yuan Wang1
1Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China.
Insights
Reinforced laryngeal masks are feasible for pediatric laparoscopic surgery in the Trendelenburg position, with low rates of suspected reflux and aspiration when fasting protocols are followed. This study assessed reflux and aspiration risks in children undergoing surgery.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Airway Management
Background:
- Laparoscopic surgery in the Trendelenburg position poses risks of reflux and aspiration in children.
- The reinforced laryngeal mask is used for airway management in pediatric surgical procedures.
Purpose of the Study:
- To determine the frequency of reflux and aspiration in children using a reinforced laryngeal mask during laparoscopic surgery in the Trendelenburg position.
- To evaluate the feasibility of using reinforced laryngeal masks in this patient population.
Main Methods:
- A descriptive study involving 300 children undergoing laparoscopic surgery in the Trendelenburg position.
- Reflux and aspiration were assessed using saliva pH measurements and observation for food residue.
- Data collected from January 2017 to May 2018 at Beijing Chaoyang Hospital.
Main Results:
- Suspected reflux was observed in 9.67% of children, and suspected aspiration in 3%.
- No definite reflux or aspiration was confirmed in any participants.
- Higher rates of suspected reflux were noted in children older than 3 years and those who were overweight.
Conclusions:
- The reinforced laryngeal mask is a feasible option for pediatric laparoscopic surgery in the Trendelenburg position.
- Strict adherence to fasting guidelines and careful patient selection are crucial for safe application.
- The study supports the use of reinforced laryngeal masks with appropriate precautions.
Objective:
To determine the frequency of reflux and aspiration in children subjected to reinforced laryngeal mask during laparoscopic surgery in the Trendelenburg position, and evaluate its feasibility.
Study Design:
A descriptive study.
Place And Duration Of Study:
Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, from January 2017 to May 2018.
Methodology:
A total of 300 children, who underwent laparoscopic high ligation of the hernial sac in the Trendelenburg position under general anesthesia, were enrolled into the present study. Reflux and aspiration were assessed by precise saliva pH to determine the pH value at laryngeal mask airway, and at sites on laryngeal mask corresponding to the larynx, face and peripheral area. Then, the presence of food residue was observed at various sites to determine whether there was reflux or aspiration during the operation.
Results:
Suspected reflux (9.67%) was observed in 29 children and suspected aspiration was observed in nine children (3%). There was no definite reflux or aspiration observed in any of the children. Furthermore, the prevalence of suspected reflux was higher in children who were >3 years and overweight, compared to children with a normal body mass index and an age of <3 years.
Conclusion:
With strict fasting and water deprivation, and strict selection of laryngeal mask indications before selective operation, it is feasible to apply reinforced laryngeal mask in laparoscopic surgery in the Trendelenburg position in children.
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