Awake removal of the laryngeal mask airway is safe in paediatric patients.

PURPOSE

It has been suggested that it is safer to remove the Laryngeal Mask Airway (LMA) in paediatric patients when they are deeply anaesthetised than when they are awake. However, the evidence regarding this recommendation is contradictory. The purpose of the study was to compare the incidence of complications (laryngeal spasm, bronchospasm, coughing, retching, excessive salivation and oxygen desaturation) associated with removal of the LMA in children.

METHODS

In a randomised study, we studied 165 ASA physical status I infants and children of both sexes, aged 2 mo to 13 yr. All patients were undergoing elective lower limb or perineal surgery. They were randomly assigned to two groups: in 83 the laryngeal mask was removed when recovery of airway reflexes had been demonstrated and the patients had opened their eyes or mouth in the recovery area. In the other 82 patients it was removed with the patient deeply anaesthetised.

RESULTS

Two (2.4%) patients developed laryngeal spasm in the anaesthetised group, one patient (1.2%) desaturated and another vomited (1.2%) in the awake group.

CONCLUSION

There was no difference in the incidence of airway complications whether the LMA was removed in the anaesthetised or the awake child.