Laryngeal mask versus intubation on adverse reactions in pediatric retinoblastoma patients
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Laryngeal Mask Airway LMA Placement in a Neonatal Patient Simulator Using a Non-Inflatable Supraglottic Airway SGA
Published on: July 14, 2023
Fei Huo1, Hansheng Liang1, Lan Gao1
1Department of Anesthesiology, Peking University People's Hospital, Beijing, China.
Insights
Laryngeal mask airway (LMA) use in pediatric eye enucleation surgery offers more stable conditions and comparable safety to endotracheal intubation (ETT). This study suggests LMA is a viable airway management option for these young patients.
Area of Science:
- Pediatric Anesthesiology
- Ophthalmologic Surgery
- Airway Management
Background:
- Enucleation surgery in children, often for retinoblastoma, necessitates general anesthesia and airway management.
- Laryngeal mask airway (LMA) and endotracheal intubation (ETT) are common pediatric anesthesia techniques.
- Comparative efficacy and safety data for LMA versus ETT in pediatric enucleation surgery are limited.
Purpose of the Study:
- To compare the efficacy and safety of LMA versus ETT in children undergoing enucleation surgery.
- To evaluate hemodynamic stability and perioperative complications associated with each airway management technique.
Main Methods:
- Retrospective review of 58 pediatric patients undergoing enucleation surgery (2007-2020).
- Patients were divided into two groups: Group A (endotracheal intubation, n=35) and Group B (laryngeal mask airway, n=23).
- Analysis included demographic data, heart rate (HR), mean arterial pressure (MAP), and perioperative complications.
Main Results:
- Laryngeal mask airway (LMA) was used in 39.66% of patients.
- Group B (LMA) showed significantly lower heart rate before skin incision compared to Group A (ETT) (P=0.02).
- One patient in Group B experienced laryngeal spasm, and another required a second LMA insertion attempt.
Conclusions:
- Laryngeal mask airway (LMA) intubation provides more stable perioperative conditions for pediatric enucleation surgery.
- LMA intubation demonstrated comparable safety to endotracheal intubation (ETT), with no increase in adverse events.
Background:
Children undergoing enucleation surgery for conditions such as retinoblastoma require general anesthesia with airway management techniques. Both laryngeal mask airway (LMA) and endotracheal intubation (ETT) are commonly used in pediatric anesthesia, but their comparative efficacy and safety in this specific context remain unclear. The objective of this study was to compare the efficacy and safety of LMA versus ETT in children undergoing enucleation surgery.
Methods:
A retrospective review of consecutive patients in Peking University People's Hospital from 2007 to 2020 who underwent eye removal surgery was included in our study. Fifty-eight eligible patients were divided into Group A (ETT, n=35) and Group B (LMA, n=23) according to the type of anesthesia. The patients' demographic data were recorded and analyzed. The heart rate (HR) and mean arterial pressure (MAP) were retrieved at different time points to compare the efficacy between LMA and ETT. Perioperative complications were recorded to compare the safety between LMA and ETT.
Results:
In total, 39.66% (23/58) of the patients received LMA. Patients with LMA placement in Group B had a significantly lower HR before skin incision than those in Group A (P=0.02). In Group B, one patient experienced laryngeal spasm after the removal of the laryngeal mask, and one patient experienced a second attempt of LMA insertion due to poor alignment of the laryngeal mask at the first time.
Conclusions:
LMA intubation provides more stable perioperative conditions for children undergoing eye enucleation surgery. LMA intubation does not generate more adverse events than ETT.
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