title: Supraglottic airway devices vs tracheal intubation in children: a quantitative meta-analysis of respiratory complications.
abstract: BACKGROUND
  Rate of perioperative respiratory complications between tracheal intubation (TI) and laryngeal mask airway remains unclear during pediatric anesthesia.
  
  
  OBJECTIVE
  The aim of the present meta-analysis was to compare the perioperative respiratory complications between laryngeal mask airway and TI.
  
  
  METHODS
  A meta-analysis of available controlled studies comparing laryngeal mask airway to TI was conducted. Studies including patients with airway infection were excluded. Data from each trial were combined to calculate the pooled odds ratios (OR) or mean difference (MD) and 95% confidence intervals.
  
  
  RESULTS
  The meta-analysis was performed on 19 studies. In 12 studies, patients were given muscle relaxation, and in 16 studies, ventilation was controlled. During recovery from anesthesia, the incidence of desaturation (OR = 0.34 [0.19-0.62]), laryngospasm (OR = 0.34 [0.2-0.6]), cough (OR = 0.18 [0.11-0.27]), and breath holding (0.19 [0.05-0.68]) was lower when laryngeal mask airway was used to secure the airway. Postoperative incidences of sore throat (OR = 0.87 [0.53-1.44]), bronchospasm (OR = 0.56 [0.25-1.25]), aspiration (1.33 [0.46-3.91]) and blood staining on the device (OR = 0.62 [0.21-1.82]) did not differ between laryngeal mask airway and TI. Results were homogenous across the studies, with the exceptions of blood staining on the device.
  
  
  CONCLUSIONS
  This meta-analysis found that the use of laryngeal mask airway in pediatric anesthesia results in a decrease in a number of common postanesthetic complications. It is therefore a valuable device for the management of the pediatric airway.
authors: Department of Anesthesia, Intensive Care, RobertDebré University Hospital, Paris, France; University Paris Diderot, Paris VII. Paris Sorbonne Cité, Paris, France.
authors: Virginie
authors: V
authors: Luce
authors: Hakim
authors: H
authors: Harkouk
authors: Christopher
authors: C
authors: Brasher
authors: Daphné
authors: D
authors: Michelet
authors: Julie
authors: J
authors: Hilly
authors: Matthieu
authors: M
authors: Maesani
authors: Thierno
authors: T
authors: Diallo
authors: Nyamjargal
authors: N
authors: Mangalsuren
authors: Yves
authors: Y
authors: Nivoche
authors: Souhayl
authors: S
authors: Dahmani
mesh_terms: D000293:Adolescent; D058109:Airway Management / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007431:Intraoperative Complications / Q000453:epidemiology; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D017214:Laryngeal Masks / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology; D012120:Respiration Disorders / Q000209:etiology* / Q000628:therapy
keywords: airway; bronchospasm; children; desaturation; laryngeal mask; laryngospasm; respiratory complications; tracheal intubation