REMOVAL OF THE LARYNGEAL MASK AIRWAY IN CHILDREN - DEEP ANESTHESIA VERSUS AWAKE

Study Objective: To compare the incidence of adverse airway events ide ntified with removal of the laryngeal mark airway (LMA) from an awake child or from a child before his or her airway reflexes had returned. Design: Prospective, randomized study. Setting: University-affiliated children's hospital. Patients: 333 ASA physical status I and II patien ts ages 1.5 to 15 years undergoing elective surgery. Interventions: At the time of removal of the LMA at the end of surgery, patients were a nesthetized or had intact airway reflexes. Measurements and Main Resul ts: Any airway problems occurring within 15 minutes of LMA removal wer e recorded. These problems included airway obstruction (laryngeal spas m and biting of the LMA), peripheral hemoglobin oxygen saturation less than 90 %, stridor requiring manipulation of the airway, vomiting, re tching, and excessive salivation. Airway problems occurred after LMA r emoval among 23 children who had their LMA removed prior to return of airway reflexes, and among 13 subjects who had their LMA removed after the return of airway reflexes. Conclusion: Removal of the LMA during anesthesia and after return of airway reflexes results in a similar in cidence of airway problems in children. (C) 1997 by Elsevier Science I nc.