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
Article Sidebar
Main Article Content
Abstract
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
References
Flexi laryngeal mask airway vs. endotracheal intubation for
paediatric ophthalmic surgery. IOSR-JDMS 2013; 4(4): 1-6
2. Gulati M, Mohta M, Ahuja S, Gupta VP. Comparison of
layngeal mask airway with tracheal tube for ophthalmic
surgery in paediatric patients. Anaesth Intensive Care 2004;
32: 383-9
3. Martin-Castro C, Montero A. Flexible laryngeal mask as an
alternative to reinforced tracheal tube for upper chest, head
and neck oncoplastic surgery. European Journal of
Anaesthesiology 2008; 25: 261-6
4. Gul R, Goksu S, Ugur BK, et al. Comparison of proseal
laryngeal mask and endotracheal tube for airway safety in
pediatric strabismus surgery. Saudi Med J 2012; 33(4):
388-94
5. Ates Y, Alanoglu Z, Uysalel A. Use of laryngeal mask airway
during ophthalmic surgery results in stable circulation and
few complications: a prospective audit. Acta Anaesthesiol
Scand 1998; 42: 1180-3
6. Biedermann S, Wodey E, De La Briere F, Pouvreau A, Ecoffey
C. Paediatric discharge score in ambulatory surgery. Ann Fr
Anesth Reanim 2014; 33: 330-334
7. Choon L. Bong, Agnes S.B. Nge. Evaluation of emergence
delirium in Asian children using the Pediatric Anesthesia
Emergence Delirium Scale. Ped Anesth 2009; 19: 593–600
8. Klockgether-Radke A, Gerhardt D, Muhlendyck H, Braun U.
Influence of the laryngeal mask airway on the incidence of
postoperative vomiting and of sore throats in children.
Anaesthesist 1996; 45(11): 1085-8
9. Zhao N, Deng F, Yu C. Anesthesia for pediatric day-case
dental surgery: a study comparing the classic laryngeal mask
airway with nasal tracheal intubation. The Journal of
Craniofacial Surgery 2014; 25(3): e245-8
10. Chavalittamrong B, Tarnpradub S, Vanprapar N. Height and
weight of Thai children: high socioeconomic group of the
some selected urban population. J Med Assoc Thai 1989;
72(4): 185-92
11. Practice guidelines for preoperative fasting and the use of
pharmacologic agents to reduce the risk of pulmonary
aspiration to healthy patients undergoing elective procedures.
Anesthesiology 2017; 126: 376-93
12. Benoit Moncel J, Nardi N, Wodey E, Pouvreau A, Ecoffey C.
Evaluation of the pediatric post anesthesia discharge scoring
system in an ambulatory unit. Ped Anesth 2015; 25: 636-641
13. Samira A, David Costifanzca, Allan M. A comparison of
emergence delirium scales following general anesthesia in
children. Ped Anesth 2010; 20(8): 704-711