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Laryngeal mask airway vs face mask and Guedel airway during pediatric myringotomy
M F Watcha1, F T Garner, P F White
1Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas.
Objective:
To compare perioperative conditions when a face mask and Guedel oral airway (FM-OA) or a laryngeal mask airway (LMA) are used to maintain airway patency during bilateral myringotomy with insertion of tympanostomy tubes (BMT).
Design:
Randomized controlled trial in children's hospital tertiary-care operating rooms.
Participants:
Fifty healthy children undergoing BMT procedures during halothane--nitrous oxide (N2O) anesthesia.
Interventions:
During BMT we managed the airway by inserting a Guedel oral airway or an LMA.
Main Outcome Measures:
We recorded the time taken to insert the airway device along with oxygen saturation during the operation and time from the end of surgery to eye opening, response to commands, and home readiness. In addition the surgeon assessed perioperative conditions on a 10-point scale (1, poor, through 10, excellent).
Results:
Although insertion of the LMA took longer than the Guedel oral airway (mean +/- SD, 9 +/- 2 seconds vs 6 +/- 2 seconds; P < .05), no differences were noted in the actual operating, anesthesia, or recovery times. However, the frequency of hypoxemic episodes was decreased (8% vs 36%, P < .05) and the lowest recorded oxygen saturations were higher (mean +/- SD, 95% +/- 7% vs 88% +/- 12%; P < .05) in the LMA group than in the FM-OA group. Surgeons rated perioperative conditions better when the LMA was used (median score, 9 vs 8; P < .05).
Conclusion:
The LMA is an excellent alternative to the FM-OA technique for airway maintenance in children undergoing BMT procedures during halothane--N2O anesthesia.