Mf. Watcha et al., LARYNGEAL MASK AIRWAY VS FACE MASK AND GUEDEL AIRWAY DURING PEDIATRICMYRINGOTOMY, Archives of otolaryngology, head & neck surgery, 120(8), 1994, pp. 877-880
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.