Abstract
To compare the safety of laryngeal mask airway removal using two different deep anaesthesia techniques in paediatric patients.The Randomized Control Trial was conducted at Aga Khan University Hospital, Karachi, from April 2012 to November 2013, and comprised patients aged 2-10 years scheduled for infraumbilical surgeries. Anaesthesia was induced with sevoflurane and later it was maintained by is oflurane, oxygen and nitrous oxide. The laryngeal mask airway was removed in the intervention group-I at 0.4 minimum alveolar concentration of isoflurane with propofol 1mg/kg. In the control group-II, it was removed at 1.2 minimum alveolar concentration of isoflurane alone. SPSS 19 was used for data analysis.Of the 50 patients, there were 25(50%) in each of the two groups. Overall, there were 46(92%) males and 4(8%) females. Incidence of airway obstruction and teeth clenching was significantly higher in group-II (p<0.05 each). Emergence duration was also significantly increased in group-II compared to group-I (p=0.001). The Post-Anaesthesia Care Unit stay timing was not significantly different between the groups (p=0.74).Laryngeal mask airway removal under deep anaesthetic technique of low-dose propofol with isoflurane was found to be associated with minimal adverse airway events than isoflurane alone in paediatric patients.
Highlights
In anaesthetic practice from its invention till this modern era, the process of laryngeal mask airway (LMA) has a significant role
There has been extensive research work done in the last decade which concludes that the process of LMA removal is completely
After obtaining approval from the institutional review board, the protocol was registered at ClinicalTrials.gov NCT01958138. with due parental consent, children with American Society of Anaesthesiologists (ASA) grade I and II aged 2-10 years planned for elective infra-umbilical surgery were enrolled using consecutive sampling method
Summary
In anaesthetic practice from its invention till this modern era, the process of laryngeal mask airway (LMA) has a significant role. It is widely used for controlling the airway in paediatric surgical patients.[1] The inventor and manufacturer formerly recommended LMA removal when the patient is fully awake and protective airway reflexes are regained.[2] these recommendations were made and practised for adults because LMA was not in practice for paediatric patients in those days.[3] Paediatric airway management is more challenging than adults due to anatomical and physiological variations.[4] In paediatric patients, LMA has great acceptance. The complication rate was remarkable with awake LMA removal in paediatrics.[4,5] There has been extensive research work done in the last decade which concludes that the process of LMA removal is completely
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