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The laryngeal mask airway in pediatric anesthesia: experience with 120 patients undergoing elective groin surgery
1Department of Anesthesia, Hadassah University Hospital, Jerusalem, Israel.
Insights
The laryngeal mask airway (LMA) is a safe and effective alternative for pediatric airway management in elective surgeries. This study found LMA insertion was successful in 95.8% of 120 children, demonstrating its utility in pediatric anesthesia.
Area of Science:
- Pediatric Anesthesiology
- Airway Management Devices
Background:
- The laryngeal mask airway (LMA) offers an alternative to traditional airway management techniques like face masks or tracheal intubation in pediatric anesthesia.
- Its efficacy and safety profile in young patients undergoing elective procedures require ongoing evaluation.
Purpose of the Study:
- To evaluate the experience and efficacy of using the laryngeal mask airway (LMA) for airway maintenance in pediatric patients undergoing elective inguinal herniorrhaphy or orchidopexy.
Main Methods:
- A prospective study involving 120 pediatric patients (1 month to 14 years) undergoing elective surgery.
- Patients were monitored using electrocardiograms, noninvasive blood pressure, pulse oximetry, and capnometry.
- Anesthesia was induced and maintained with halothane, nitrous oxide, and oxygen, with LMA size selected based on patient weight.
Main Results:
- The laryngeal mask airway (LMA) was successfully inserted in 115 out of 120 patients (95.8%), with 100 insertions on the first attempt.
- Ease of insertion was consistent across different LMA sizes and patient weight groups.
- Anesthesia was maintained for an average of 39.2 minutes with halothane.
Conclusions:
- The laryngeal mask airway (LMA) is a highly effective and easily inserted device for airway management in pediatric patients undergoing elective inguinal herniorrhaphy or orchidopexy.
- Its successful application in this cohort supports its role as a valuable tool in pediatric anesthesia practice.
Abstract:
The laryngeal mask airway (LMA) was recently introduced in pediatric anesthesia as an alternative to the face mask or tracheal intubation for airway maintenance. The authors report their experience with LMA on 120 consecutively treated children who underwent elective inguinal herniorrhaphy or orchidopexy. The patients were monitored with electrocardiograms, noninvasive blood pressure determinations, pulse oxymetry, and capnometry. Anesthesia was induced and maintained with halothane, nitrous oxide, and oxygen. There were 96 males and 24 females; the age range was 1 month to 14 years (average, 3.2 years). They weighed between 2.5 and 46 kg (mean, 14 kg). Patients were allowed to breath spontaneously until anesthesia was deep enough (average, 6.3 minutes; range, 2 to 15 minutes). The appropriate-size LMA was inserted and inflated, and patients were divided into three groups. Group I patients (n = 24) weighed 2.6 to 6 kg and received LMA size no. 1. Group II (n = 84) weighed 6 to 30 kg and received LMA size no. 2. Group III (n = 12) weighed more than 30 kg and received LMA size no. 3. Patients in groups II and III breathed spontaneously; those in group I were on volume-controlled ventilation. The LMA was easily inserted in 115 patients (95.8%)--on the first attempt in 100, and on the second attempt in 15. In five patients, LMA was successfully inserted on the third attempt. The ease of insertion was not significantly different between the groups. Anesthesia was maintained by halothane (mean, 1.34%; range, 0.8% to 2.54%) for an average of time of 39.2 minutes (range, 15 to 90 minutes).(ABSTRACT TRUNCATED AT 250 WORDS)