LMA Extubation in Pediatric Patients: A Comparison of Inflated and Deflated LMA Cuff Methods

Mahin Seyedhejazi ,Behzad Aliakbari Sharabiani ,Hamid Ahmadpour ,Daryoush Sheikhzadeh ,Marjan Dehdilani

doi:10.7575/aiac.abcmed.14.02.02.07

Mahin Seyedhejazi , Behzad Aliakbari Sharabiani + Show 3 more

Open Access

https://doi.org/10.7575/aiac.abcmed.14.02.02.07

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Abstract

Background and Objectives: Extubating LMA (Laryngeal mask airway) can be performed either with inflated or deflated cuff . In this study the effects and complications of these two methods were compared in children . Materials and Methods: In a clinical trial, 180 patients under 11 years old with ASA I/II who were scheduled for elective surgeries for less than one hour with no need for muscle relaxation were randomly divided into two groups. In group D, LMAs were extubated after oral cavity suctioning and cuff deflation. In group I, LMAs were extubated without suctioning and deflating the cuffs. Results: In group I after removing the LMA, mean heart rate significantly increased, mean diastolic blood pressure significantly increased, and mean arterial blood saturation significantly decreased. In Group D, none of these changes occurred. Despite a higher incidence of complications in the group I, difference was not significant. Conclusions: LMA removal with inflated cuff increases hemodynamic changes and decreases the arterial blood saturation. Hence, when hemodynamic stability and saturation of arterial blood is particularly important for us, extubating the LMA with deflated cuff is recommended. Keywords: LMA; Complication; Inflated; Deflated

Highlights

Airway management has always been of great importance for physicians [1]
Patients were divided into two groups: Group D (LMA removed deflated after suctioning around Laryngeal mask airway (LMA) and oral cavity) and Group I (LMA removal inflated and without suction)
180 patients were evaluated during the LMA removal in the two groups with inflated cuff (n=90) and deflated cuff (n=90)

Summary

Introduction

Airway management has always been of great importance for physicians [1]. Laryngeal mask airway (LMA) is considered as a standard and acceptable device for supporting the airway in both adults and children [2]. Use of LMA requires careful insertion and removal. It has been mentioned in many resources that the laryngeal mask should be removed if the patient is fully awake to prevent the possible complications that may occur [11, 12]. Extubating LMA (Laryngeal mask airway) can be performed either with inflated or deflated cuff. In group D, LMAs were extubated after oral cavity suctioning and cuff deflation. In group I, LMAs were extubated without suctioning and deflating the cuffs. Conclusions: LMA removal with inflated cuff increases hemodynamic changes and decreases the arterial blood saturation. When hemodynamic stability and saturation of arterial blood is important for us, extubating the LMA with deflated cuff is recommended.

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Results

Conclusion