Can Positive-Pressure Ventilation be Administered with Laryngeal Mask to Pediatric Patients Undergoing Laparoscopic Inguinal Hernia Operation?

OBJECTIVES

We aimed to investigate the effects of intubation and laryngeal mask airway (LMA) use by evaluating the results of blood gas tests, end-tidal CO measurements, and airway changes during laparoscopic inguinal hernia repair in children.

METHODS

This study was designed to be a prospective randomized study enrolling 150 ASA-I patients, aged 1-8 years; who were scheduled for laparoscopic inguinal hernia repair. Group 1 (n=75) received general anesthesia with fentanyl, propofol, and rocuronium and they were orotracheally intubated. Group 2 (n=75) received general anesthesia with fentanyl and propofol and were inserted an LMA. Demographical data were recorded. Arterial blood gas test results at baseline, in the 10 min after the insufflation, and in the 10 min after the end of the insufflation were noted. The end-tidal CO, HR, SPO, inspiratory pressure, plateau pressure, tidal volume (TV), and respiratory frequencies were recorded. The duration of anesthesia, operation, and insufflations was noted. Emergent complications were recorded.

RESULTS

The duration of both anesthesia and recovery was longer in Group 1 compared to Group 2. Hemodynamical parameters, end-tidal CO values, TVs, airway pressures, and respiratory frequencies were not statistically significantly different between the groups. There were no statistically meaningful differences in the levels of pH, PCO, and PO between the groups.

CONCLUSION

Compared to orotracheal intubation during laparoscopic inguinal surgery; LMA did not cause any statistically significant differences in the blood gas test results or airway pressures and recovery was faster with LMA. Therefore, LMA can be used in pediatric laparoscopic surgery as a safe tool for maintaining the airway.