Comparison of laryngeal mask airway, cuffed and uncuffed tracheal tubes in pediatric patients during general anesthesia

Abstract

American Heart Association and the International Liaison Committee on Resuscitation have now accepted cuffed tubes as an alternative to uncuffed ones for pediatric airway. Recently laryngeal mask airway (LMA) has become increasingly popular as an alternative device for airway management in children. The present study was undertaken to evaluate and compare LMA, cuffed and uncuffed Endo tracheal tube (ETT) as airway devices in small children during general anesthesia. The study included 150 patients of age 2-6 years undergoing elective surgery under general anesthesia and randomized to one of the three groups depending on airway device insertion i.e. Group C: Cuffed ETT; Group P: Uncuffed ETT; Group L: cLMA. Variables depicting ease of insertion, hemodynamic parameters and airway morbidity were recorded and assessed. The time taken for insertion of airway device as well as total duration of device in situ was statistically similar in the three groups. First attempt success rate was significantly higher in the cuffed ETT group. Change in size of device was required in 4%, 36.0% and 16.0% patients in groups C, P and L respectively. Number of failures in groups C, P and L respectively was 2%, 0% and 4% (p>0.05). Hypertensive tachycardiac response was minimum in cLMA group. All the three groups were comparable with respect to overall airway morbidity. We conclude that all the three devices including cuffed ETT can be used safely in the pediatric age group.