A comparison of awake versus deep removal of laryngeal mask airway in children aged 2 to 8 years who underwent ophthalmic procedures at menilik ii hospital: cohort study

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Addis Ababa Universty


Background: Laryngeal mask airway is a useful airway device which provides an alternative to ventilation through a face mask or endotracheal tube. It can be removed either when a child awakens or deeply anesthetized. However, there is no objective evidence to choose one over the other. It has been studied by various investigators but with conflicting results and conclusions. Objective: The aim of the study was to compare awake removal of laryngeal mask airway with deep removal regarding to airway related adverse events. Methodology: A prospective observational cohort study was conducted at Menelik-II hospital from January to April 2018. Sixty two American Society of Anesthesiologists physical status I and II pediatric (aged 2-8 years) patients who underwent ophthalmic procedures under laryngeal mask airway with halothane as maintenance anesthesia were recruited by systematic random sampling technique. Airway related adverse events following deep condition of laryngeal mask airway removal (deep group) versus awake condition removal (awake group) were recorded by trained data collectors. Fisher’s exact test were used to analyze breath holding, coughing, and biting. The remaining upper airway obstruction, excessive salivation, and desaturation were analyzed using Chi-square test. Demographic data (age, and weight) were analyzed by independent t test except gender (analyzed by Chi-square test). Results: The incidence of coughing (12.9% versus 6.5%), upper airway obstruction (41.9% versus 35.5%), breath holding (9.7% versus 3.2%), desaturation (16.1% versus 22.6%), excessive salivation (19.4% versus 12.9%), and biting (6.5% versus 0%) between awake and deep group was not different (p > 0.05). Laryngospasm, vomiting, and retching did not occur in either group. Conclusion: There was no significant difference in the incidence of airway related adverse events whether the laryngeal mask airway was removed in deep or awake condition.



Laryngeal mask airway