title: Short-lasting pediatric laparoscopic surgery: Are muscle relaxants necessary? Endotracheal intubation vs. laryngeal mask airway.
abstract: OBJECTIVE
  Technical advances have led to lower insufflation pressures and shorter anesthesia times for children undergoing laparoscopic procedures. In this study we compared the use of endotracheal tube (ETT) and laryngeal mask airway (LMA) with or without muscle relaxant (MR) in children undergoing laparoscopic repair for inguinal hernia.
  
  
  METHODS
  Children undergoing laparoscopic inguinal hernia repair were randomized into four groups which underwent procedure with either ETT+MR (group 1), ETT without MR (group 2), LMA with subparalytic dose of MR (group 3) or LMA without MR (group 4). Surgical, anesthesia and recovery times, intragastric pressures and peak airway pressures during insufflation were compared.
  
  
  RESULTS
  After exclusion criteria and discontinued interventions, groups 1 and 3 contained 20, groups 2 and 4 contained 19 patients each. Surgical times were similar between groups. Anesthesia times were statistically significantly different between groups with shortest time in group 4 and longest time in group 1. Recovery time was statistically significantly longer in group 1 when compared to other groups. There was no difference between basal intragastric pressure, average intragastric pressure during insufflation, peak airway pressure, and average peak airway pressure during insufflation of groups.
  
  
  CONCLUSIONS
  Use of muscle relaxants in short-lasting laparoscopic procedures in children is not absolutely necessary and LMA with subparalytic dose of muscle relaxant or with no muscle relaxant is a safe alternative.
  
  
  METHODS
  Treatment study.
  
  
  METHODS
  Level II.
authors.affiliation: Maltepe University Faculty of Medicine, Department of Anesthesiology & Reanimation, Istanbul, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Tulgar
authors.affiliation: Pendik State Hospital, Department of Anesthesiology & Reanimation, Istanbul,Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Boga
authors.affiliation: Hisar Intercontinental Hospital, Department of Urology, Istanbul, Turkey.
authors.forename: Basri
authors.initials: B
authors.lastname: Cakiroglu
authors.affiliation: Maltepe University Faculty of Medicine, Department of Pediatric Surgery, Istanbul, Turkey. Electronic address: david@thomas.md.
authors.forename: David Terence
authors.initials: DT
authors.lastname: Thomas
mesh_terms: D000768:Anesthesia, General; D002648:Child; D002675:Child, Preschool; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007442:Intubation, Intratracheal; D010535:Laparoscopy / Q000379:methods*; D017214:Laryngeal Masks; D008297:Male; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D009466:Neuromuscular Blocking Agents
keywords: Laparoscopy; Muscle relaxant; Pediatric