The Use of the Laryngeal Mask Airway in Children with Bronchopulmonary Dysplasia

• Published in: Anesthesia and analgesia Vol. 81; no. 2; pp. 310 - 313
• Main Authors: Ferrari, Lynne R., Goudsouzian, Nishan G.
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD International Anesthesia Research Society 01.08.1995; Lippincott
• Subjects: Anesthesia; Anesthesia depending on patient's condition; Anesthesia Recovery Period; Anesthesia, Inhalation; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Pressure; Bronchopulmonary Dysplasia - physiopathology; Carbon Dioxide - metabolism; Child, Preschool; Cough - etiology; Halothane - administration & dosage; Hoarseness - etiology; Humans; Infant; Infant, Newborn; Infant, Premature; Intubation, Intratracheal - adverse effects; Laryngeal Masks - adverse effects; Medical sciences; Patient Discharge; Pulse; Respiration; Respiratory Sounds - etiology; Tidal Volume; Vitrectomy - methods; Human; Premature; Lung disease; Respiratory disease; Mask; Respiratory intensive care; General anesthesia; Newborn diseases; Bronchus disease; Complication; Bronchopulmonary dysplasia; Larynx; Intubation; Child; Trachea; Comparative study
• ISSN: 0003-2999; 1526-7598
• DOI: 10.1097/00000539-199508000-00018

Airway maintenance with the laryngeal mask airway (LMA) was evaluated and compared to the endotracheal (ET) tube in 27 former premature infants and children with bronchopulmonary dysplasia (BPD) during second stage open-sky vitrectomy. The children were randomly assigned to a study group and anesthetized with halothane in N2 O:O2. The airway was maintained with the LMA (n = 13) or the ET tube (n = 14). Respiratory and hemodynamic variables were recorded. Intraoperative and postoperative complications were noted. The respiratory rate and the end-tidal CO (2) were significantly higher in the LMA group as compared with the ET tube group (P < 0.01); however, the pulse rate and both systolic and diastolic blood pressures throughout the surgical procedure were lower in the LMA group (P < 0.05). The incidence of coughing, with and without desaturation, wheezing, and hoarseness in the postoperative period was higher in the ET tube group. Awakening, after discontinuation of the anesthetic (P < 0.01) was more rapid, and home discharge time (P < 0.002) was shorter in the LMA group (P < 0.0025), although our study design could not isolate the use of the LMA as the factor responsible for this. This study in patients with mild chronic lung disease demonstrated that the LMA can maintain a satisfactory airway during minor surgical procedures in children with bronchopulmonary dysplasia and result in fewer respiratory adverse effects than with the ET tube.(Anesth Analg 1995;81:310-3)