THE USE OF THE LARYNGEAL MASK AIRWAY IN CHILDREN WITH BRONCHOPULMONARY DYSPLASIA

Airway maintenance with the laryngeal mask airway (LMA) was evaluated and compared to the endotracheal (ET) tube in 27 former premature infa nts and children with bronchopulmonary dysplasia (BPD) during second s tage open-sky vitrectomy. The children were randomly assigned to a stu dy group and anesthetized with halothane in N2O:O-2. The airway was ma intained with the LMA (n = 13) or the ET tube (n = 14). Respiratory an d hemodynamic variables were recorded. Intraoperative and postoperativ e complications were noted. The respiratory rate and the end-tidal CO2 were significantly higher in the LMA group as compared with the ET tu be group (P < 0.01); however, the pulse rate and both systolic and dia stolic blood pressures throughout the surgical procedure were lower in the LMA group (P < 0.05). The incidence of coughing, with and without desaturation, wheezing, and hoarseness in the postoperative period wa s higher in the ET tube group. Awakening, after discontinuation of the anesthetic (P < 0.01) was more rapid, and home discharge time (P < 0. 002) was shorter in the LMA group (P < 0.0025), although our study des ign could not isolate the use of the LMA as the factor responsible for this. This study in patients with mild chronic lung disease demonstra ted that the LMA can maintain a satisfactory airway during minor surgi cal procedures in children with bronchopulmonary dysplasia and result in fewer respiratory adverse effects than with the ET tube.