title: Laryngeal mask airway is associated with an increased incidence of adverse respiratory events in children with recent upper respiratory tract infections.
abstract: BACKGROUND
  The laryngeal mask airway (LMA) has been advocated as an alternative technique to tracheal intubation for airway management of children with recent upper respiratory tract infections (URIs). The authors determined the occurrence of adverse respiratory events and identified the associated risk factors to assess the safety of LMA in children.
  
  
  METHODS
  During a period of 5 months, parents of children scheduled to undergo general anesthesia with an LMA were asked to fill out a questionnaire regarding their child's medical history and potential symptoms of URI. In addition, all episodes of adverse respiratory events in the perioperative period (laryngospasm, bronchospasm, coughing, airway obstruction, and oxygen desaturation) as well as details of anesthesia management were recorded.
  
  
  RESULTS
  Among the 831 children included in the study, 27% presented with a history of a recent URI within the last 2 weeks before anesthesia. The presence of a recent URI doubled the incidence of laryngospasm (odds ratio, 2.6; 95% confidence interval, 1.3-5.0), coughing (odds ratio, 2.7; 95% confidence interval, 1.7-4.3), and oxygen desaturation (odds ratio, 1.9; 95% confidence interval, 1.2-2.8). This incidence was even higher in young children; in those undergoing ear, nose, and throat surgery; and when there were multiple attempts to insert the LMA.
  
  
  CONCLUSIONS
  An LMA used in children with recent URIs was associated with a higher incidence of laryngospasm, cough, and oxygen desaturation compared with healthy children. However, the overall incidence of adverse respiratory events was low, suggesting that if anesthesiologists allow at least a 2-week interval after a URI, they can safely proceed with anesthesia using an LMA.
authors: Pediatric Anesthesia Unit, Geneva Children's Hospital, University Hospitals of Geneva, Geneva, Switzerland.
authors: Britta S
authors: BS
authors: von Ungern-Sternberg
authors: Krisztina
authors: K
authors: Boda
authors: Craig
authors: C
authors: Schwab
authors: Craig
authors: C
authors: Sims
authors: Chris
authors: C
authors: Johnson
authors: Walid
authors: W
authors: Habre
mesh_terms: D000768:Anesthesia, General / Q000379:methods; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003371:Cough / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D017214:Laryngeal Masks / Q000009:adverse effects* / Q000706:statistics & numerical data*; D007826:Laryngismus / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D011446:Prospective Studies; D012120:Respiration Disorders / Q000453:epidemiology*; D012141:Respiratory Tract Infections / Q000453:epidemiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires