Comparison of Recovery Time to Discharge Criteria following Ophthalmic Surgery in Pediatric Patients under General Anesthesia with Flexible Laryngeal Mask Airway versus Endotracheal Tube: A Prospective, Randomized Controlled Trial

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Pichanun Pulsawat


Background: The flexible laryngeal mask airway is an
alternative airway device used for providing general
anesthesia in pediatric ophthalmic surgery besides the
endotracheal tube. Recent studies demonstrated the better
outcome of using flexible laryngeal mask airway over
endotracheal tube in reducing incidence of hypoxemia,
bronchospasm, postoperative cough and sore throat.
Objectives: The objective of study was to determine the
recovery time to discharge criteria in pediatric patients
following ophthalmic surgery under general anesthesia
with flexible laryngeal mask airway compared with
endotracheal tube.
Material and Method: Pediatric patients aged 1-10 years
old who scheduled for elective ophthalmic surgery under
general anesthesia in King Chulalongkorn Memorial
Hospital were randomized into 2 groups. Flexible laryngeal
mask airway was used as airway device during anesthesia
in fLMA group, while patients in ETT group were intubated
with endotracheal tube. Primary outcome was the recovery
time to discharge criteria which was evaluated using the

Ped-PADSS. Secondary outcomes were perioperative
complications related to anesthesia.
Results: A total of 40 pediatric patients (21 in ETT group
and 19 in fLMA group) completed the study analysis. There
were no statistically significant difference between two
groups in median time to discharge criteria, defined as
Ped-PADSS score ≥ 9 (p-value=0.233). Although there
were more patients in ETT group reached the discharge
score than patients in fLMA group at 10 minutes after
PACU arrival, the difference was not statistically
significant (95.24%vs73.68%; p=0.085). The incidence of
postoperative complications related to anesthesia was
not statistically different between two groups of patients.
Conclusion: There was no statistical and clinical
superiority of using flexible laryngeal mask airway to
endotracheal tube in recovery time with home readiness
discharge criteria after general anesthesia for pediatric
ophthalmic surgery.

Article Details

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