Efficacy and safety of the laryngeal mask airway vs Guedel airway following tracheal extubation

Purpose: To compare the safety and efficacy of the laryngeal mask airway (L MA) with the Guedel airway during the recovery period, Methods: In a prospective randomised trial in the Past Anesthesia Care Unit (PACU), 52 patients (ASA 1 and 2) were randomised to receive either a lary ngeal mask airway (LMA: n = 26) or a Guedel airway(n = 26) during the recov ery period after middle ear surgery. Ease of airway maintenance was graded and the presence of coughing was noted. Peripheral arterial oxygen saturati on (SpO(2)) was measured continuously by pulse oximetry in the PACU. Readin gs were taken on arrival (time 0) and for five minutes afterwards. Results: There was no difference in sex, age, weight or incidence of smokin g between the two groups. In the LMA group 25 patients required no airway m anipulation and only one patient required repositioning of the LMA. In the Guedel group severe difficulty maintaining the airway was experienced in tw o patients, moderate difficulty in five patients and mild difficulty in 12 patients, Seven patients required no airway manipulation, The IMA group sho wed higher ease of airway maintenance scores, (P = < 0.0001) and less cough ing (P = 0.0496). At time 0 and at one minute the LMA group had higher medi an SpO(2) (97% and 97%) than the Guedel group (95% and 96%), (P = 0.0002 an d 0.0362). There was no further difference in SpO(2). Conclusions: The LMA provides easier airway maintenance, less coughing and initially higher median SpO(2) when compared with the Guedel airway in the recovery period.