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BJA Advance Access originally published online on April 7, 2007
British Journal of Anaesthesia 2007 98(6):802-805; doi:10.1093/bja/aem070
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Removal of the laryngeal tube in children: anaesthetized compared with awake

J. Lee, J. Kim, S. Kim, C. Kim, T. Yoon and H. Kim*

Department of Anesthesiology, Seoul National University College of Medicine, Seoul, Korea

* Corresponding author: Department of Anesthesiology, Seoul National University College of Medicine, Seoul, Korea # 28 Yongondong, Jongnogu, Seoul, Korea. E-mail: dami0605{at}snu.ac.kr

Background: Laryngeal tube (LT) is a useful airway device in children, but there is no objective evidence that removal of LT in awake state is better than in anaesthetized state. So, we compared the incidence of respiratory adverse events after the removal of LT, either under anaesthesia or on awakening.

Methods: Seventy healthy children between 1 and 12 yr of age were enrolled in this study. Anaesthesia was induced and maintained with sevoflurane. After induction of anaesthesia, patients were randomized into two groups: removal of LT in anaesthetized state (Group A: 2% sevoflurane) and in awake state (Group B). During and within 1 min of the removal of LT, airway complications such as upper airway obstruction, cough, vomiting, teeth clenching, hypersalivation, desaturation <90%, and laryngospasm were recorded.

Results: Cough (37.1 vs 2.9%), hypersalivation (28.6 vs 5.7%), desaturation (20 vs 0%), and LT dislocation during emergence relating to the patient's movement (26.5 vs 0%) occurred more frequently in Group B (P < 0.05). Upper airway obstruction occurred more frequently (68.6 vs 31.4%) in Group A, and it was easily resolved by chin or jaw lifting.

Conclusion: LT removal in anaesthetized state reduced cough, hypersalivation, and prevented tube displacement and hypoxia. Upper airway obstruction in the anaesthetized state should be predicted and managed with chin or jaw lifting.

Keywords: anaesthesia, paediatric; airway, laryngeal tube, removal


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E-letters:

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Yes, LMA removal asleep provides smooth emergence
Santhanam Suresh
British Journal of Anaesthesia, 25 May 2007 [Full text]
Removal of the laryngeal tube in children: anaesthetized compared with awake
muhammad farooq
British Journal of Anaesthesia, 29 May 2007 [Full text]
Structural difference might explain...
Hee-Soo Kim
British Journal of Anaesthesia, 1 Jun 2007 [Full text]

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