Comparison of the Effect of Laryngeal Mask Airway Versus Endotracheal Tube on Airway Management in Pediatric Patients with Tonsillar Hypertrophy

Xiang Liu; Hongyan Cao; Xiaona Tan; Li Qiao; Qi Zhang; Lei Shi

doi:10.1016/j.jopan.2020.06.020

Comparison of the Effect of Laryngeal Mask Airway Versus Endotracheal Tube on Airway Management in Pediatric Patients with Tonsillar Hypertrophy

J Perianesth Nurs. 2021 Apr;36(2):142-146. doi: 10.1016/j.jopan.2020.06.020. Epub 2020 Nov 6.

Authors

Xiang Liu¹, Hongyan Cao¹, Xiaona Tan², Li Qiao¹, Qi Zhang¹, Lei Shi³

Affiliations

¹ Department of Operating Room and Anesthesiology, Hebei Medical University Affiliated Children's Hospital of Hebei Province, Shijiazhuang, China.
² Department of Neurological Rehabilitation, Hebei Medical University Affiliated Children's Hospital of Hebei Province, Shijiazhuang, China.
³ Department of Operating Room and Anesthesiology, Hebei Medical University Affiliated Children's Hospital of Hebei Province, Shijiazhuang, China. Electronic address: shileilx@163.com.

PMID: 33168406
DOI: 10.1016/j.jopan.2020.06.020

Abstract

Purpose: The laryngeal mask airway (LMA) has become an important choice in both routine and difficult airway management. We aimed to evaluate the safety and effectiveness of LMA use in pediatric patients with tonsillar hypertrophy.

Design: This study was a randomized controlled trial.

Methods: The study included 100 pediatric patients who had first or second degree tonsillar hypertrophy. Pediatric patients undergoing elective laparoscopic inguinal hernia repair were randomly divided into two groups (n = 50): LMA group and the endotracheal tube (ETT) group. The primary outcomes were ventilation leak volume, peak airway pressure, and partial pressure of end-tidal carbon dioxide (P_ETco₂). Data for primary outcomes were collected before and 5-, 15-, and 25-minute after opening pneumoperitoneum, and on closing the pneumoperitoneum. Complications such as laryngospasm, bronchospasm, desaturation, severe coughing, blood on the device after removal, and sore throat were recorded.

Findings: A total of 100 pediatric patients were assessed and 97 eligible patients were randomly assigned to receive an LMA (n = 49) or an ETT (n = 48). There was no statistically significant difference in ventilation leak volume and P_ETco₂ between the LMA and ETT groups (P > .05). Compared with T_1-4, peak airway pressure was significantly lower in T₀ (LMA group 12.6 ± 0.9, 95% confidence interval 12.2 to 13.0; ETT group 12.8 ± 1.2, 95% confidence interval 12.2 to 13.3; P < .05). The incidences of laryngospasm 11 (22.9%), desaturation 18 (37.5%), and severe coughing 13 (27%) were higher in the ETT group (11 [22.9%] vs 3 [6.1%], 18 [37.5%] vs 6 [12.2%], 13 [27%] vs 3 [6.1%]; P < .05).

Conclusions: The application of LMA has a lower incidence of complications. LMA as an airway device is effective and perhaps superior in appropriate patients.

Keywords: anesthesia, general; children; supraglottic airway; surgical procedures, laparoscopic; tonsillar hypertrophy.

Publication types

Randomized Controlled Trial

MeSH terms

Child
Humans
Hypertrophy
Intubation, Intratracheal / adverse effects
Laryngeal Masks* / adverse effects
Laryngismus*
Pharyngitis*