Use of the laryngeal mask airway during repair of atrial septal defect in children

We describe the elective use of the laryngeal mask airway in two children u ndergoing cardiopulmonary bypass for repair of an atrial septal defect. Tot al surgical time was short and cardiopulmonary bypass performed at normothe rmia allowing removal of the laryngeal mask airway on the operating table o n completion of surgery. We were able to adequately oxygenate and ventilate the children throughout the procedure using positive pressure ventilation and spontaneous ventilation. The use of caudal fentanyl and rectal diclofen ac aided postoperative pain management. Atrial septal defect repair has bec ome one of the more straightforward cardiac operations partly as a result o f new cardiopulmonary bypass techniques. Avoidance of intubation and postop erative ventilation in appropriate patients would make this procedure ideal for 'fast tracking' and offers the potential advantages of decreased lengt h of stay in hospital and reduction in overall costs.