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Topical Airway Anesthesia for Awake-endoscopic Intubation Using the Spray-as-you-go Technique with High Oxygen Flow
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Removal of the laryngeal mask airway in children: anaesthetized compared with awake

A J Kitching1, A R Walpole, C E Blogg

  • 1Nuffield Department of Anaethetics, Radcliffe Infirmary, Oxford.

British Journal of Anaesthesia
|June 1, 1996
PubMed

Insights

Removing the laryngeal mask airway from anesthetized children significantly reduced postoperative coughing compared to removal during awakening. This finding is crucial for pediatric anesthesia safety.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery

Background:

  • The laryngeal mask airway (LMA) is commonly used in pediatric anesthesia.
  • Postoperative coughing is a frequent complication after LMA removal.
  • Optimizing LMA removal technique may improve patient outcomes.

Purpose of the Study:

  • To compare the incidence of postoperative coughing after LMA removal during awakening versus deep anesthesia in children undergoing plastic surgery.

Main Methods:

  • A randomized controlled trial involving 60 children (12 months to 8 years) undergoing plastic surgery.
  • Patients were randomized to LMA removal either upon awakening or while still anesthetized.
  • Respiratory factors and oxygen saturation were monitored postoperatively.

Main Results:

  • A significantly lower incidence of coughing was observed when the LMA was removed during deep anesthesia (2/27) compared to removal during awakening (17/33; P < 0.001).
  • No significant differences were found in laryngospasm, desaturation, or excess salivation between the groups.

Conclusions:

  • Removing the laryngeal mask airway during deep anesthesia is an effective strategy to reduce immediate postoperative coughing in pediatric patients.
  • This technique may enhance patient comfort and safety in the postoperative period following general anesthesia.

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