Laryngeal Mask Anesthesia for Pediatric Ophthalmic and Adult Strabismus Surgery

Abstract

Purpose:To evaluate the laryngeal mask airway as an alternative to endotracheal intubation for pediatric ophthalmic and adult strabismus surgery.Methods:Laryngeal mask airways were used in 119 cases. Ten cases were intubated due to pre-operative risk factors or anesthetist preference. Peripheral oxygen saturation, expired carbon dioxide, EKG, blood pressure, and temperature were monitored prior to, during, and following removal of the airway. Patients or parents were contacted the night following surgery to document emesis and other anesthesia-related problems.Results:Laryngeal mask airways were successfully placed and managed in 118 cases (99%). The device would not stay positioned in one patient due to anomalous pharyngeal anatomy, necessitating intubation. One patient developed laryngospasm as the LMA was inserted, requiring intravenous succinlycholine prior to replacing the device.No other patient had airway or systemic problems during or immediately following removal of the device. Minor positioning difficulties were observed in four cases managed by inexperienced anesthetists. Emesis occurred during the first 12 hours following surgery in 15% of patients. Patients and/or parents were positive about post-anesthesia recovery in all cases.Conclusion:When inserted and managed by trained anesthetists, the laryngeal mask airway is a safe and effective alternative to endotracheal intubation for pediatric ophthalmic and adult strabismus surgery.