AWAKE REMOVAL OF THE LARYNGEAL MASK AIRWAY IS SAFE IN PEDIATRIC-PATIENTS

Purpose: It has been suggested that it is safer to remove the Laryngea l Mask Airway (LMA) in paediatric patients when they are deeply anaest hetised than when they are awake. However, the evidence regarding this recommendation is contradictory. The purpose of the study was to comp are the incidence of complications (laryngeal spasm, bronchospasm, cou ghing, retching, excessive salivation and oxygen desaturation) associa ted with removal of the LMA in children, Methods: In a randomised stud y, we studied 165 ASA physical status 1 infants and children of both s exes, aged 2 mo to 13 yr. All patients were undergoing elective lower limb or perineal surgery. They were randomly assigned to two groups: i n 83 the laryngeal mask was removed when recovery of airway reflexes h ad been demonstrated and the patients had opened their eyes or mouth i n the recovery area. In the other 82 patients it was removed with the patient deeply anaesthetised. Results: Two (2.4%) patients developed l aryngeal spasm in the anaesthetised group, one patient (1.2%) desatura ted and another vomited (1.2%) in the awake group. Conclusion: There w as no difference in the incidence of airway complications whether the LMA was removed in the anaesthetised or tile awake child.