Comparison of the Effect of Laryngeal Mask Airway Versus Endotracheal Tube on Airway Management in Pediatric Patients with Tonsillar Hypertrophy.

Purpose: The laryngeal mask airway (LMA) has become an important choice in both routine and difficult airway management. We aimed to evaluate the safety and effectiveness of LMA use in pediatric patients with tonsillar hypertrophy.

Design: This study was a randomized controlled trial.

Methods: The study included 100 pediatric patients who had first or second degree tonsillar hypertrophy. Pediatric patients undergoing elective laparoscopic inguinal hernia repair were randomly divided into two groups (n = 50): LMA group and the endotracheal tube (ETT) group. The primary outcomes were ventilation leak volume, peak airway pressure, and partial pressure of end-tidal carbon dioxide (Pco). Data for primary outcomes were collected before and 5-, 15-, and 25-minute after opening pneumoperitoneum, and on closing the pneumoperitoneum. Complications such as laryngospasm, bronchospasm, desaturation, severe coughing, blood on the device after removal, and sore throat were recorded.

Findings: A total of 100 pediatric patients were assessed and 97 eligible patients were randomly assigned to receive an LMA (n = 49) or an ETT (n = 48). There was no statistically significant difference in ventilation leak volume and Pco between the LMA and ETT groups (P > .05). Compared with T, peak airway pressure was significantly lower in T (LMA group 12.6 ± 0.9, 95% confidence interval 12.2 to 13.0; ETT group 12.8 ± 1.2, 95% confidence interval 12.2 to 13.3; P < .05). The incidences of laryngospasm 11 (22.9%), desaturation 18 (37.5%), and severe coughing 13 (27%) were higher in the ETT group (11 [22.9%] vs 3 [6.1%], 18 [37.5%] vs 6 [12.2%], 13 [27%] vs 3 [6.1%]; P < .05).

Conclusions: The application of LMA has a lower incidence of complications. LMA as an airway device is effective and perhaps superior in appropriate patients.