Objective: To determine the frequency of reflux and aspiration in children subjected to reinforced laryngeal mask during laparoscopic surgery in the Trendelenburg position, and evaluate its feasibility.
Study design: A descriptive study.
Place and duration of study: Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, from January 2017 to May 2018.
Methodology: A total of 300 children, who underwent laparoscopic high ligation of the hernial sac in the Trendelenburg position under general anesthesia, were enrolled into the present study. Reflux and aspiration were assessed by precise saliva pH to determine the pH value at laryngeal mask airway, and at sites on laryngeal mask corresponding to the larynx, face and peripheral area. Then, the presence of food residue was observed at various sites to determine whether there was reflux or aspiration during the operation.
Results: Suspected reflux (9.67%) was observed in 29 children and suspected aspiration was observed in nine children (3%). There was no definite reflux or aspiration observed in any of the children. Furthermore, the prevalence of suspected reflux was higher in children who were >3 years and overweight, compared to children with a normal body mass index and an age of <3 years.
Conclusion: With strict fasting and water deprivation, and strict selection of laryngeal mask indications before selective operation, it is feasible to apply reinforced laryngeal mask in laparoscopic surgery in the Trendelenburg position in children.