Prospective, randomized comparison of laryngeal tube and laryngeal mask airway in pediatric patients.
BACKGROUND
While reports of the use of laryngeal mask airway (LMA)-Classic in great patient numbers are available, data on the use of the laryngeal tube (LT) in this age group is limited. The two devices are compared in a prospective randomized trial to evaluate success rates and quality of airway seal.


METHODS
Sixty children, aged 2-8 years, scheduled for elective surgical interventions were randomized to be ventilated with LMA or LT. Standardized anesthesia was induced with fentanyl and propofol. Number of insertion attempts, time until first tidal volume and intraoperative tidal volumes, and peak pressures were recorded. Airway leak pressure was measured with cuff pressure adjusted to 60 cmH(2)O.


RESULTS
Demographic data were comparable, average age in the LMA/LT group was 5.2 +/- 1.9/5.3 +/- 1.9 years. Insertion was successful in 29 of 30 patients in the LMA group (second attempt 8) and in all patients in the LT group (second attempt 3). Time until first tidal volume for LMA/LT was 23.1 +/- 7.3/19.2 +/- 8.6 s (P < 0.05). Peak airway pressures for LMA and LT were 15.3 +/- 3.4 and 17.1 +/- 4.0 cmH(2)O (P < 0.05) with tidal volumes of 10.2 +/- 2.2 and 10.2 +/- 1.9 ml.kg(-1), airway leak pressure was 19.2 +/- 8.6 cmH(2)O for LMA and 26.3 +/- 7.3 cmH(2)O for LT (P < 0.001).


CONCLUSIONS
Insertion success rate is high with both LMA and LT in the age group studied. The airway leak pressure, serving as an estimate to judge quality of airway seal, is higher with the LT.
Genzwuerker
H V
HV
Clinic of Anaesthesiology and Intensive Care Medicine, University Hospital Mannheim, Mannheim, Germany. harald.genzwuerker@anaes.ma.uni-heidelberg.de
Fritz
A
A
Hinkelbein
J
J
Finteis
T
T
Schlaefer
A
A
Schaeffer
M
M
Thil
E
E
Rapp
H J
HJ
D000399:Air Pressure; D000768:Anesthesia, General / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation; D017214:Laryngeal Masks / Q000009:adverse effects; D008297:Male; D008991:Monitoring, Physiologic; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies