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Structural difference might explain...
- Hee-Soo Kim (1 June 2007)
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Removal of the laryngeal tube in children: anaesthetized compared with awake
- muhammad farooq (29 May 2007)
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Yes, LMA removal asleep provides smooth emergence
- Santhanam Suresh (25 May 2007)
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Hee-Soo Kim
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Thank you for your concern. In my opinion unlike LMA, LT seems to be displaced easier than LMA upon the patients' emergence. The distal balloon of LT is placed in the esophageal inlet and as the patient is awkening the sphincter tone of the esophagus returns and the esophageal inlet pressure increses therefore the distal balloon of LT seems to be easily displaced and consequently LT might interfere ventilation. As mentioned above, the shape of LT is different from LMA therefore it is favorable to extubate LT in deep anesthesia than awake state. Conflict of Interest:None declared |
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muhammad farooq, doctor AMNCH DUBLIN
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Letter to editor I read this article with intrest. I want to add that my own experience is that if the child is breathing spontaneously with LMA, it is always better to take the LMA out when the child is still anaesthetised. This is because desaturation is unlikely in a spontaneously breathing anaesthetised child because of lesser chance of laryngeal spasm as a respnse to foreign body in throat. Conflict of Interest:None declared |
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Santhanam Suresh, Pediatric Anesthesiologist Children's Memorial Hospital
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We have been using the technique described by the authors for many years since we introduced the LMA as a routine part of our anesthetic management. One word of caution, in the patient who has a difficult airway, I feel that it may be worthwhile waiting for them to be awake since the LMA prevents airway obstruction. The older children and adolescents (>12 years) routinely seem to wake up better with the LMA in place and the risk for desaturation is much less. Conflict of Interest:None declared |
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