Laryngeal Mask Airway In Children With Short Surgery

Objective To evaluate the usage of the pediatric laryngeal mask airway, and to provide the basis for the application and promotion., we compare the pediatric laryngeal mask airway with tracheal tube in short surgery. Methods 65 children in 8 months-13years old with short operation (expected operation time≤2 hours) at the First Affiliated Hospital of Guangxi Medical University during August 2010 to December 2010 were collect.All patients were divided into the LMA group (LMA group,32cases) and tracheal intubation (ETT group,33cases). Both groups were was induced with propofol 3mg/kg and fentanyl 3μg/kg, ETT group received vecuronium 0.1mg/kg. LMA group select the appropriate laryngeal mask airway to insert, ETT group choose the endotracheal tube to place. The respiratory parameters was adjusted according the PETCO2. Both groups were 2% -3% sevoflurane inhalation and propofol 10mg/kg intravenous infusion to maintain anesthesia.Recorded cases of children of each before, during and after the operation, including preoperative gender, age, weight, ASA classification, LMA insertion number of operations, aeration rate, before LMA insertion (T1), after LMA insertion (T2), beginning of operation (T3), 15 minutes after the start of surgery (T4), the end of surgery (T5), the time of pull out (T6) ,the heart rate (HR), blood pressure (BP ), pulse oxygen saturation (SpO2), pressure end-tidal CO2 partial (PET CO2), the time of the surgical start and end, LMA removal time, leaving PACU time. Record the intraoperative and postoperative adverse effects . Results (1) The two groups were gender, age, ASA grade had no statistically significant differences. (P> 0.05).(2) Two patients were failure of LMA implantations,they were turn into tracheal intubations, not included in LMA group.(3)Two groups of patients in the SpO2had no significant differences, where no hypoxemia (SpO2≤94%), carbon dioxide waveform stable, PETCO2 was no more than 40cmH2O. LMA group and the ETT group, after placement of airway protections, LMA group'peak airway pressure was lower than the ETT', it was statistically significant, P <0.05. The usage of LMA have smaller impact than the ETT, P <0.05. (4) Removal of airway device time in children after surgery and recovery room staying time in LMA group's was shorter than the ETT group's,P <0.05. the number of coughting and flatulence in LMA group was less than in ETT group.Conclusion Pediatric Laryngeal Mask Airway in short surgery is safe and feasible, as long as the appropriate depth of anesthesia maintain well, the LMA can be used as a substitute for endotracheal intubation application.