Timing of Withdrawal of the Laryngeal Mask Airway (LMA) in Children

Timing of Withdrawal of the Laryngeal Mask Airway (LMA) in Children: Early or Late Removal?

The purpose of this prospective, randomized study was to compare the incidence of adverse events associated with removal of the LMA either in deeply anesthetised or awake patients.

Written informed consent was obtained from parents for this prospective, randomized study conducted on children scheduled for minor surgery. Anesthesia was induced with sevoflurane, supplemented with propofol (3mg/kg) then maintained with nitrous oxide and sevoflurane 2-4% in oxygen. Analgesia was insured by peripheral nerve blocks. Included children were randomized into 2 groups:

• Awake: the LMA was left in place until the patient fully regained consciousness
• Deeply anesthetised: the LMA was immediately removed once the halogenated anesthetic turned off, and ventilation using facial mask was carried until spontaneous ventilation recovery.

Respiratory complications that occurred during LMA removal until 20 minutes afterwards were recorded. Children with respiratory history and those for whom peripheral nerve blocks failed, were excluded.

Inclusion Criteria:

• Children scheduled for minor surgery

Exclusion Criteria:

• None