Related Experiment Video
Updated: Nov 18, 2025
Anesthesia and Intubation of Preadolescent Mouse Pups for Cardiothoracic Surgery
Published on: June 2, 2022
[Different anesthesia management in preterm infants undergoing surgeries for retinopathy of prematurity: A
1Department of Anesthesiology, Peking University People's Hospital, Beijing, China, 100044, China.
Insights
Laryngeal mask airway (LMA) anesthesia without muscle relaxants facilitated earlier extubation and reduced apnea in premature infants undergoing retinopathy of prematurity (ROP) surgery compared to endotracheal tube (ETT) anesthesia. This approach improved recovery outcomes for these vulnerable patients.
Area of Science:
- Anesthesiology
- Neonatal Surgery
- Ophthalmology
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Anesthesia management in premature infants undergoing ROP surgery requires careful consideration of clinical outcomes.
- Different airway management strategies, including laryngeal mask airway (LMA) and endotracheal tube (ETT), may impact postoperative recovery.
Purpose of the Study:
- To compare the clinical outcomes of anesthesia management using LMA versus ETT in former prematurely born infants undergoing ROP surgery.
- To evaluate the impact of different anesthesia techniques on perioperative adverse events, extubation time, and length of hospital stay.
Main Methods:
- Retrospective study analyzing electronic medical records of premature infants (<37 weeks gestational age) undergoing ROP surgery.
- Patients were divided into two groups: LMA insertion without muscle relaxants and ETT with muscle relaxants.
- Primary outcomes included perioperative adverse events; secondary outcomes were extubation time and length of stay.
Main Results:
- The incidence of intraoperative adverse events was similar between LMA and ETT groups.
- LMA group showed significantly lower incidence of difficult extubation and apnea during early recovery compared to ETT group.
- Median extubation time was shorter, and median length of hospital stay was significantly reduced in the LMA group.
Conclusions:
- Laryngeal mask airway (LMA) insertion without muscle relaxants is a viable anesthesia strategy for ROP surgery in premature infants.
- This technique facilitates earlier extubation and reduces the incidence of apnea during the early recovery period.
- LMA anesthesia may lead to improved postoperative recovery and shorter hospital stays for this patient population.
Objective:
To evaluate the effect of different anesthesia management on clinical outcomes in former prematurely born infants undergoing surgeries for retinopathy of prematurity (ROP).
Methods:
In this retrospective study, electronic medical record database was searched for all former prematurely born infants (gestational age < 37 weeks and post conceptual age < 60 weeks) who received ROP surgery under inhalational general anesthesia between November 2016 and October 2018. The patients were divided into two groups based on anesthesia management: laryngeal mask airway (LMA) insertion without intravenous muscle relaxant injection and with pressure support ventilation (LMA group) or airway secured with endotracheal tube (ETT) with intravenous muscle relaxant injection and pressure controlled ventilation (ETT group). Primary outcomes included perioperative adverse events and complications. Extubation time and length of stay after surgery were also recorded.
Results:
Sixty eight preterm infants in the LMA group and 100 preterm infants in the ETT group were included. The incidence of adverse events during surgery (including airway management change and desaturation) was similar in LMA group and ETT group (4.4% vs. 1.0%, P =0.364). During the early recovery period after surgery, the incidence of difficult extubation (extubation time >30 min) was significantly lower in LMA group compared with ETT group (4.4% vs.15.0%, RR=0.262, 95%CI:0.073－0.942, P=0.029). The incidence of respiratory events was similar between the two groups (20.6% vs. 27.0%, P =0.342). However, the incidence of apnea was significantly lower in the LMA group than in the ETT group (5.9% vs.19.0%, RR=0.266, 95%CI: 0.086－0.822, P =0.015). No significant difference was observed between the LMA group and ETT group in incidences of cardiovascular events (0% vs. 1.0%, P =1.000) and unplanned admission to neonatal intensive care unit (5.9% vs. 7.0%, P=0.774). No airway spasm, re-intubation, aspiration or regurgitation was observed during early recovery. During late recovery after returning to ward, the incidence of adverse events was also similar between the two groups (0% vs. 2.0%, P =0.241). The median (IQR) extubation time was 6 (5, 10) min in LMA group and 10 (6, 19) min in ETT group (P < 0.001). The median length of stay after surgery was significantly shortened in LMA group compared with ETT group [20 (17, 22) hours vs. 22 (17, 68) hours, P =0.002].
Conclusion:
Compared with endotracheal intubation with intravenous muscle relaxant injection, laryngeal mask airway insertion without muscle relaxant could achieve an early extubation, and reduce the incidence of apnea during early recovery period in former prematurely born infants undergoing ROP surgery.
Related Concept Videos
01:24General Anesthesia: Overview
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
01:24Parenteral Anesthetics: Overview