Experiences with use of the laryngeal mask with flexible, wire reinforced tube for ENT interventions in childhood

Abstract

This is a report on experiences regarding the use of the reinforced laryngeal mask airway for 121 minor operations in paediatric otolaryngology. By far the most interventions were adeno-tonsillectomies (104), which until now were performed under general anaesthesia with tracheal intubation. The rate of observed complications was surprisingly low. 117 children were able to undergo their operation using the laryngeal mask airway. Tracheal intubation became necessary four times (failure to bring laryngeal mask into position occurred twice, laryngospasm occurred once, cough/pressing caused by lack of adequate depth of anaesthesia in two cases). In five cases there were problems of ventilation (4.1%), provoked by the Boyle-Davis gag. Seven children complained of postoperative sore throat, a complication that could be avoided later by measuring the cuff pressure (25-70 cm H2O). Aspiration was not observed in any of the cases. The complete absence of choking or pressing was regarded as particularly favourable by both the anesthetist and the surgeon. The use of the reinforced laryngeal mask airway during paediatric otolaryngological operations in the hand of an experienced anaesthetist appears to be a promising alternative to tracheal intubation and merits more widespread use.