Use of laryngeal mask airway in children with upper respiratory tract infection, compared with face mask: Randomized, single blind, clinical trial

Abstract 

Objective

The incidence of postoperative cough (primary outcome) and adverse respiratory events (secondary outcome) in children who received anesthesia by laryngeal mask airway (LMA) with children who received anesthesia by face mask (FM) was compared in a blind randomized trial with uncomplicated upper respiratory track infection (URI) undergoing general anesthesia. Previous studies of pediatric patients with URI receiving anesthesia by endotracheal tube have reported a greater number of anesthetic complications; however reports concerning adverse effects in pediatric patients with URI receiving anesthesia by LMA or FM are scanty.

Method

For the present trial, 150 children with uncomplicated URI and requiring general anesthesia for ophthalmic procedures were enrolled. Once the severity of preoperative URI symptoms was stratified, the children were randomized to receive general anesthesia by FM or LMA. Anesthesia was induced with sevoflurane and nitrous oxide in oxygen (N₂O in O₂). Respiratory adverse events were evaluated peri- and post-operatively.

Results

The two groups did not differ in age, weight, American Society of Anesthesiologists (ASA) physical status, sex, duration of surgery or severity of URI symptoms. The incidences of cough (19% in LMA vs. 42% in FM), vomiting (4% in LMA vs. 12% in FM) and intervention to maintain the patency of the airway were statistically higher in the FM group (p<0.05). There were no differences between the two groups with respect to the incidences of apnea, laryngospasm, desaturation, bronchospasm, readmission and sore throat.

Conclusion

In children with uncomplicated URI, the administration of inhalation anesthetics in general anesthesia by LMA is likely to cause fewer adverse events than the use of FM.

Key words: anesthesia, child, face masks, laryngeal masks, respiratory tract infections