Anesthesia for pediatric gastroscopy: a study comparing the ProSeal laryngeal mask airway with nasal cannulae.

Background: We tested the hypothesis that pediatric gastroscopy is more successful using the ProSeal laryngeal mask airway with the drain tube as a conduit to the stomach (ProSeal LMA group) than using nasal cannulae with conventional oral access to the stomach (NC group).

Methods: Sixty children were consecutively and randomly allocated into each group. Patients breathed spontaneously and were given sevoflurane/air/oxygen mixture with propofol 1 mg.kg-1 boluses, as required. Anesthesia was provided by experienced users of both techniques. The following data were collected by an unblinded observer: operation and anesthesia times; cardiorespiratory data; adverse events; and recovery scores. In addition, the surgeon scored the ease of performing the procedure.

Results: The mean (range) age and weight was 74 (24-144) months and 26 (10-61) kg. Operation (15 min vs 24 min, P<0.0001) and anesthesia (22 min vs 37 min, P<0.0001) times were shorter in the ProSeal LMA group, but propofol bolus requirements per unit time were similar. Oxygen saturation was higher in the ProSeal LMA group (100% vs 94%, P<0.0006), but other cardiorespiratory variables were similar. There were no differences in the ease of performing the procedure. Hypoxia occurred more frequently in the NC group (20% vs 0%). Recovery scores were similar.

Conclusions: We conclude that pediatric gastroscopy is quicker and has fewer airway complications when performed through the ProSeal LMA than using nasal cannulae and a conventional approach by experienced users.