LARYNGEAL MASK AIRWAY VS FACE MASK AND GUEDEL AIRWAY DURING PEDIATRICMYRINGOTOMY

Objective: To compare perioperative conditions when a face mask and Gu edel oral airway (FM-OA) or a laryngeal mask airway (LMA) are used to maintain airway patency during bilateral myringotomy with insertion of tympanostomy tubes (BMT). Design: Randomized controlled trial in chil dren's hospital tertiary-care operating rooms. Participants: Fifty hea lthy children undergoing BMT procedures during halothane-nitrous oxide (N2O) anesthesia. Interventions: During BMT we managed the airway by inserting a Guedel oral airway or an LMA. Main Outcome Measures: We re corded the time taken to insert the airway device along with oxygen sa turation during the operation and time from the end of surgery to eye opening, response to commands, and home readiness. In addition the sur geon assessed perioperative conditions on a 10-point scale (1, poor, t hrough 10, excellent). Results: Although insertion of the LMA took lon ger than the Guedel oral airway (mean +/- SD, 9 +/- 2 seconds vs 6 +/- 2 seconds; P<.05), no differences were noted in the actual operating, anesthesia, or recovery times. However, the frequency of hypoxemic ep isodes was decreased (8% vs 36%, P<.05) and the lowest recorded oxygen saturations were higher (mean +/- SD, 95% +/- 7% vs 88% +/- 12%; P<.0 5) in the LMA group than in the FM-OA group. Surgeons rated perioperat ive conditions better when the LMA was used (median score, 9 vs 8; P<. 05). Conclusion: The LMA is an excellent alternative to the FM-OA tech nique for airway maintenance in children undergoing BMT procedures dur ing halothane-N2O anesthesia.