ETT Vs LMA In Pediatric Patients With URI: A Comparison Of Adverse Respiratory Events

Abstract

Anaesthesiologists are usually conservative in accepting children with URI (Upper Respiratory Tract Infection) for surgery and cases are scheduled for a later symptom free date. This is for fear of aiway hyper-reactivity and its associated complications which are a major concern to the anaesthesiologist. It is for this reason that we conducted the present study to see if children with mild URI or those diagnosed by the pediatrician as having allergic rhinitis (with out any symptoms of viral URI or LRTI) can be taken up for surgery with extra vigilance and whether LMA could serve as an appropriate substitute in minimizing the adverse respiratory events associated with URI. 40 children were divided equally in to two groups. In group I (n=20) LMA was used as an airway device. In group II (n=20) endotracheal intubation was done. Results were evaluated statistically by chi-square method and Fisher's exact test and p<0.05 was taken as significant. We found that the incidence of cough, secretions and breath holding was lower in group I but the difference was not statistically significant. The incidence of laryngospasm was equal in both the groups. The difference in incidence of SPO2 desaturation and broncho spasm was statistically significant with group I showing a lower incidence. From the above we conclude that children with mild URI may be taken up for surgery with a little extra caution and extending the observation of children till the stay in the PACU and LMA definitely offers a suitable alternative to ETT in paediatric patients with URI.