Ventilation with the laryngeal tube in pediatric patients undergoing elective ambulatory surgery.
BACKGROUND
The laryngeal tube is a new supraglottic alternative for securing the airway. Few data on the use of this airway device in pediatric patients are so far available. Experiences of the study are reported.


METHODS
Use of the laryngeal tube for ventilation during intermittent positive-pressure ventilation was studied in an open, noncomparative observational study in 80 pediatric patients (age: 2-12 years) undergoing elective ambulatory surgery. Insertion success, time to achieve a patent airway, and occurrence of adverse events were documented.


RESULTS
Mean (sd) patient age was 5.8 (2.3) years. The laryngeal tube was placed at the first attempt in 90% of patients, a second attempt was necessary in 6%. Ventilation was not possible after two attempts in three patients. Mean (sd) tidal volume was 10.1 (2.0) ml.kg(-1) with a mean (sd) peak airway pressure of 15.6 (2.1) cmH(2)O. Chin lift was applied to improve ventilation in 15 patients (18.8%). Laryngospasm occurred in one patient, but ventilation was possible after adapting depth of anesthesia. Mean (sd) time for airway maintenance was 11.2 (3.7) s. No gastric insufflation of air occurred, no traces of blood could be detected after removal of the device. One patient complained of mild problems (swallowing, VAS 1). Mean (sd) anesthesia time was 44 (9) min.


CONCLUSIONS
In the age group studied, the laryngeal tube provides a rapid, patent airway in the majority of patients with a low complication rate.
Genzwuerker
Harald V
HV
Institute of Anaesthesiology and Intensive Care Medicine, University Hospital Mannheim, Mannheim, Germany. harald.genzwuerker@anaes.ma.uni-heidelberg.de
Hohl
Eva Ch
ECh
Rapp
Hans-Juergen
HJ
D000556:Ambulatory Surgical Procedures; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007385:Intermittent Positive-Pressure Ventilation; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods*; D007830:Larynx; D008297:Male; D016343:Monitoring, Intraoperative; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods*; D013990:Tidal Volume / Q000502:physiology