1
|
Brennan MP, Webber AM, Patel CV, Chin WA, Butz SF, Rajan N. Care of the Pediatric Patient for Ambulatory Tonsillectomy With or Without Adenoidectomy: The Society for Ambulatory Anesthesia Position Statement. Anesth Analg 2024:00000539-990000000-00799. [PMID: 38517763 DOI: 10.1213/ane.0000000000006645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2024]
Abstract
The landscape of ambulatory surgery is changing, and tonsillectomy with or without adenoidectomy is one of the most common pediatric surgical procedures performed nationally. The number of children undergoing tonsillectomy on an ambulatory basis continues to increase. The 2 most common indications for tonsillectomy are recurrent throat infections and obstructive sleep-disordered breathing. The most frequent early complications after tonsillectomy are hemorrhage and ventilatory compromise. In areas lacking a dedicated children's hospital, these cases are managed by a nonpediatric specialized anesthesiologist and general otolaryngology surgeon. In response to requests from our members without pediatric fellowship training and/or who care for pediatric patients infrequently, the Pediatric Committee of the Society for Ambulatory Anesthesia (SAMBA) developed a position statement with recommendations for the safe perioperative care of pediatric patients undergoing tonsillectomy with and without adenoidectomy in freestanding ambulatory surgical facilities. This statement identifies children that are more likely to experience complications and to require additional dedicated provider time that is not conducive to the rapid pace and staffing ratios of many freestanding ambulatory centers with mixed adult and pediatric practices. The aim is to provide health care professionals with practical criteria and suggestions based on the best available evidence. When high-quality evidence is unavailable, we relied on group consensus from pediatric ambulatory specialists in the SAMBA Pediatric Committee. Consensus recommendations were presented to the Pediatric Committee of SAMBA.
Collapse
Affiliation(s)
- Marjorie P Brennan
- From the Department of Anesthesiology, Pain and Perioperative Medicine, The George Washington University School of Medicine, Children's National Hospital, Washington, DC
| | - Audra M Webber
- University of Rochester School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York
| | - Chhaya V Patel
- Department of Anesthesiology and Pediatrics, Emory School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Wanda A Chin
- Department of Anesthesiology and Perioperative Medicine, New York University Grossman School of Medicine, NYU Lagone Health, New York, New York
| | - Steven F Butz
- Department of Anesthesiology, Medical College of Wisconsin, Children's Wisconsin Surgicenter
| | - Niraja Rajan
- Department of Anesthesiology, Penn State Milton S Hershey Medical Center, Hershey Outpatient Surgery Center, Hershey, Pennsylvania
| |
Collapse
|
2
|
Webb N, Kars MS, Butler AL, Malesinska M, Smith LP. The use of laryngeal mask airway for tonsillectomy and adenoidectomy. Int J Pediatr Otorhinolaryngol 2021; 144:110691. [PMID: 33773427 DOI: 10.1016/j.ijporl.2021.110691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/05/2021] [Accepted: 03/18/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Patients undergoing tonsillectomy and adenoidectomy traditionally receive anesthesia with endotracheal intubation (ETT) for airway management. The laryngeal mask airway (LMA) may be used instead and may be associated with less airway stimulation and shorter operating room times. The purpose of this study was to report on a large cohort of patients undergoing tonsillectomy and/or adenoidectomy while using the LMA for airway maintenance during anesthesia. METHODS Patients undergoing tonsillectomy and adenoidectomy between January 6, 2017 and January 6, 2020 with a LMA were reviewed for safety outcomes. We compared two cohorts of patients with LMA and ETT to analyze the effect on operating room times. RESULTS Our study identified 1042 patients who met criteria for review. The incidence of cases requiring conversion to ETT (1.2%) and laryngospasm (0.3%) in our cohort is lower than previously suggested by the literature. The patients who underwent surgery with the LMA spent less time in the operating room (p = 0.004) compared to the ETT group. CONCLUSION The use of the LMA may be a safe and effective option for airway management during tonsillectomy and adenoidectomy. There may be a benefit of OR time reduction in patients undergoing anesthesia with an LMA compared to ETT.
Collapse
Affiliation(s)
- Nathaniel Webb
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY, 11549, USA
| | - Michelle S Kars
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY, 11549, USA; Department of Anesthesiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY, 11549, USA
| | - Alan L Butler
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY, 11549, USA; Department of Anesthesiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY, 11549, USA
| | - Monika Malesinska
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY, 11549, USA; Department of Anesthesiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY, 11549, USA
| | - Lee P Smith
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY, 11549, USA; Division of Pediatric Otolaryngology, Steven and Alexandra Cohen Children's Medical Center of New York, 430 Lakeville Road, New Hyde Park, NY, 11042, USA.
| |
Collapse
|
3
|
Naguib TM, Ahmed SA. Evaluation of Flexible Laryngeal Mask Airway ® in Tongue Trauma Repair: A Randomized Trial. Anesth Pain Med 2019; 9:e92929. [PMID: 31750096 PMCID: PMC6820298 DOI: 10.5812/aapm.92929] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 05/31/2019] [Accepted: 06/21/2019] [Indexed: 01/28/2023] Open
Abstract
Background Flexible laryngeal mask airway may be used instead of the endotracheal tube in children presented for elective repair of tongue trauma, as it may shorten the time for extubation and recovery with the amelioration of stress response to airway management. Objectives This study aimed to evaluate the extubation time and hemodynamic response to the endotracheal tube or flexible laryngeal mask airway in children presented for tongue trauma repair. Methods The study recruited 90 children presented for elective repair of tongue trauma that were randomly assigned into the following groups: the ETT group for which the airway was controlled by a cuffed endotracheal tube and the LMA group for which the airway was controlled by a flexible laryngeal mask. The intubation time, surgical time, total anesthesia time, extubation time, recovery time, changes in the hemodynamic parameters, and the incidence of complications were measured. Results The use of flexible laryngeal mask airway instead of endotracheal tube significantly decreased the extubation time to 7.47 ± 2.74 min (P < 0.0001) and the recovery time to 52.67 ± 11.16 min (P = 0.001) while no significant differences were observed in the intubation time (P = 0.874), surgical time (P = 0.411), and total anesthesia time (P = 0.725). In addition, the changes in the hemodynamic parameters were significantly lower with flexible laryngeal mask airway both during airway securing and at the start of the surgery (P < 0.05). Moreover, it significantly decreased the incidence of postoperative cough, stridor, and sore throat (P = 0.039, 0.006, and 0.027, respectively). Conclusions The flexible laryngeal mask airway can be used instead of the endotracheal tube in children undergoing the repair of tongue trauma, as it decreases the extubation time, recovery time, and hemodynamic changes to the airway control.
Collapse
Affiliation(s)
| | - Sameh Abdelkhalik Ahmed
- Department of Anesthesia and Intensive Care, Tanta University, Tanta, Egypt
- Corresponding Author: Lecturer of Anesthesiology and Intensive Care, Faculty of Medicine, Tanta University, Saied st., Tanta, Elgharbia Governate, Egypt. Tel: +20-1002977048.
| |
Collapse
|
4
|
Gehrke T, Hackenberg S, Steinhübel B, Hagen R, Scherzad A. Laryngeal mask versus intubation for adenoidectomies in children: Analysis of 1,500 operations. Laryngoscope 2019; 129:E383-E388. [DOI: 10.1002/lary.27794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2018] [Indexed: 11/12/2022]
Affiliation(s)
- Thomas Gehrke
- Department of Otorhinolaryngology–Head and Neck SurgeryUniversity Hospital Würzburg Würzburg Germany
| | - Stephan Hackenberg
- Department of Otorhinolaryngology–Head and Neck SurgeryUniversity Hospital Würzburg Würzburg Germany
| | - Bernhard Steinhübel
- Department of Anesthesiology and Intensive Care MedicineUniversity Hospital Würzburg Würzburg Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology–Head and Neck SurgeryUniversity Hospital Würzburg Würzburg Germany
| | - Agmal Scherzad
- Department of Otorhinolaryngology–Head and Neck SurgeryUniversity Hospital Würzburg Würzburg Germany
| |
Collapse
|
5
|
Ozmete O, Sener M, Caliskan E, Kipri M, Aribogan A. The use of flexible laryngeal mask airway for Adenoidectomies: An experience of 814Paediatric patients. Pak J Med Sci 2017; 33:823-828. [PMID: 29067047 PMCID: PMC5648946 DOI: 10.12669/pjms.334.12432] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess flexible laryngeal mask airway (F-LMA) use during pediatric adenoidectomies in terms of patient safety, comfort, complication rates and surgeon satisfaction levels. METHODS Patients who had undergone an elective adenoidectomy after receiving general anesthesia using F-LMA from June 2012 to November 2015 were included. Patients' demographics and the incidence of perioperative complications were investigated. The surgeon's satisfaction level was also evaluated by questionnaire. RESULTS Eight hundred fourteen patient were included in the study. Conversion from F-LMA to an endotracheal tube was carried out in two patients (0.2%). Airway complications were identified in two patients. The mean duration of stay in the postoperative anesthesia care unit was 17 minutes. All patients were discharged the same day. According to the otolaryngologists F-LMA applications provide a significant reduction in the processing time (100%), postoperative patient comfort is better than when using endotracheal intubation (83.3%) and the consensus was that there should be a complete continuation of the use of the F-LMA (100%) in subsequent adenoidectomies. CONCLUSION Our data show that the use of F-LMA for pediatric adenoidectomies has well tolerability profile and resulted in a lower incidence of complications. We think that the use of F-LMA for pediatric adenoidectomy is safer, simpler and speeder method.
Collapse
Affiliation(s)
- Ozlem Ozmete
- Ozlem Ozmete, MD, Department of Anesthesiology and Reanimation, Baskent University School of Medicine, Adana, Turkey
| | - Mesut Sener
- Prof. MesutSener, MD, Department of Anesthesiology and Reanimation, Baskent University School of Medicine, Adana, Turkey
| | - Esra Caliskan
- Asocc. Prof. Esra Caliskan, MD, Department of Anesthesiology and Reanimation, Baskent University School of Medicine, Adana, Turkey
| | - Meltem Kipri
- Meltem Kipri, MD, Department of Anesthesiology and Reanimation, Baskent University School of Medicine, Adana, Turkey
| | - Anis Aribogan
- Prof. Anis Aribogan, MD, Department of Anesthesiology and Reanimation, Baskent University School of Medicine, Adana, Turkey
| |
Collapse
|
6
|
Hettige R, Pankhania M, Demetriou V, Draper M. Laryngeal mask airways and use of a Boyle-Davis gag in ENT surgery: is there a learning curve? A prospective analysis. Ann Otol Rhinol Laryngol 2014; 123:338-42. [PMID: 24668055 DOI: 10.1177/0003489414526365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The objective was to identify whether the experience of the operating surgeon was relevant to the frequency of the laryngeal mask airway (LMA) airway obstruction or change to an endotracheal tube during ear, nose, and throat surgery. METHODS Data were prospectively collected for 186 patients undergoing a procedure with the use of a Boyle-Davis gag and LMA over 12 months in a district-general hospital in the United Kingdom. patient demographics (age, mallampati grade), grade of surgeon, grade of anesthetist, LMA size inserted, and any intraoperative adjustments needed were recorded. RESULTS There was an overall intraoperative airway intervention rate of 21%. The experience of the surgeon affected the rate of intraoperative airway interventions encountered, reflected by the significantly lower rate of airway complications (ie, 10%) seen when associate specialists perform these types of procedures compared to other grades of surgeon (Fisher's exact test 2-tailed P value = .04). A significant complication rate of 50% was seen with core surgical trainees compared to other grades of surgeon (Fisher's exact test 2-tailed P value = .002). CONCLUSIONS The results of this study suggest there may be a learning curve for otolaryngology trainees when using a LMA. However, larger studies and further subanalyses are essential before further conclusions can be made.
Collapse
Affiliation(s)
- Roland Hettige
- Department of Otolaryngology, Royal Berkshire Hospital, Oxford Deanery, UK
| | | | | | | |
Collapse
|
7
|
Abstract
BACKGROUND AND OBJECTIVES Tracheal intubation associated with airway operations can cause complications such as laryngospasm, bronchospasm and periods of reduced oxygen saturation. Such complications are frequently reported during adenotonsillectomies, a procedure that by nature increases the incidence of airway complications. The objective of this study was to compare the occurrence of respiratory problems during adenotonsillectomies while using either a disposable laryngeal mask airway (LMA) or an endotracheal tube (TT). METHODS We evaluated 204 pediatric patients undergoing general anesthesia for adenotonsillectomies. The patients were randomly allocated into either the tracheal intubation group (TT, n=100) or the laryngeal mask airway group (LMA, n=104). It was measured the level of oxygen saturation by pulse oximetry (SpO(2)) after the induction of anesthesia (SpO(2)-1), after establishing the operative field (SpO(2)-2), at the end of the surgical procedure (SpO(2)-3), three minutes after the removal of the contained breathing apparatus (SpO(2)-4) and upon admission to the post-anesthesia care unit (SpO(2)-5). All respiratory complications were recorded. RESULTS The mean SpO(2) values and standard deviations for the TT and LMA groups were as follows: SpO(2)-1: 98.9±1.0 and 98.7±0.8 (p>0.25), SpO(2)-2: 97.4±1.0 and 94.9±4.3 (p<0.001), SpO(2)-3: 96.9±1.1 and 97.2±1.1 (p=0.037), SpO(2)-4: 91.7±9.0 and 95.2±2.2 (p<0.001) and SpO(2)-5: 94.0±2.1 and 95.8±2.6 (p<0.001), respectively. In the LMA group, 12 patients required some maneuvering to fix positioning and leaks during surgery. In four patients, the LMA had to be replaced with a TT. Respiratory complications were similar between groups. CONCLUSIONS Performing adenotonsillectomies in pediatric patients using a LMA resulted in a lower intraoperative SpO(2), compared to using a TT. In some cases, the LMA had to be replaced with an endotracheal tube. Although the surgery may be performed with LMA, the use of a TT is preferred for safety.
Collapse
|
8
|
The use of the laryngeal mask airway in ENT surgery: Facts and fiction. TRENDS IN ANAESTHESIA AND CRITICAL CARE 2013. [DOI: 10.1016/j.tacc.2013.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
9
|
Lalwani K, Richins S, Aliason I, Milczuk H, Fu R. The laryngeal mask airway for pediatric adenotonsillectomy: predictors of failure and complications. Int J Pediatr Otorhinolaryngol 2013; 77:25-8. [PMID: 23063385 DOI: 10.1016/j.ijporl.2012.09.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 09/07/2012] [Accepted: 09/14/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We hypothesize that the laryngeal mask airway (LMA) is a safe technique for airway management in pediatric adenotonsillectomy (T&A). METHODS After institutional review board (I.R.B.) approval, we conducted a retrospective review of 1199 medical records of children who underwent T&A from 2002 to 2006 at Doernbecher Children's Hospital, a teaching institution in Portland, OR. There were no significant demographic differences between the LMA (n=451), endotracheal tube (ETT) (n=715), and failed LMA groups (n=33). Outcome variables were LMA failure (LMA replaced with endotracheal tube), and any complication. We collected demographic and medical data to determine the incidence and predictors of LMA failure, and to characterize the failed LMA group. RESULTS The incidence of LMA failure was 6.8%. Patients who underwent adenoidectomy had significantly lower odds of LMA failure compared to patients who had a tonsillectomy or adenotonsillectomy (OR 0.28, 95% CI 0.15-0.52, P<0.0001). One of the surgeons (OR 0.46, 95% CI 0.45-0.48, P<0.0001) was also associated with decreased odds of LMA failure. Controlled ventilation (OR 7.17, 95% CI 4.99-10.32, P<0.0001), and younger patients (OR 1.05 for each year decrease in age, 95% CI 1.03-1.07, P ≤ 0.0001) were associated with increased odds of LMA failure. The complication rate was 14.2% in the LMA group and 7.7% in the ETT group. Increased odds of developing any complication were seen in male patients (OR 1.4, 95% CI 1.01-1.7, P=0.04), and in patients with co-morbidities other than obstructive sleep apnea syndrome or upper respiratory tract infection (OR 4.2, 95% CI 1.03-17.2, P=0.04). The odds of developing a complication were lower in the ETT group compared to the LMA group (0.63, 0.46, 0.8, P=0.005). CONCLUSIONS LMA use for pediatric T&A is associated with a higher incidence of complications, mainly as a result of airway obstruction following insertion of the LMA or McIvor gag placement. Complications were more likely if tonsillectomy was performed when compared to adenoidectomy alone. Appropriate patient selection, careful insertion, and avoidance of controlled ventilation may decrease the incidence of LMA failure, especially if tonsillectomy is performed. The ability of surgeons to work around the LMA can modify the failure rate significantly.
Collapse
Affiliation(s)
- Kirk Lalwani
- Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, OR, USA.
| | | | | | | | | |
Collapse
|
10
|
Sierpina DI, Chaudhary H, Walner DL, Villines D, Schneider K, Lowenthal M, Aronov Y. Laryngeal mask airway versus endotracheal tube in pediatric adenotonsillectomy. Laryngoscope 2012; 122:429-35. [DOI: 10.1002/lary.22458] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Accepted: 10/24/2011] [Indexed: 11/10/2022]
|
11
|
Jefferson N, Riffat F, McGuinness J, Johnstone C. The laryngeal mask airway and otorhinolaryngology head and neck surgery. Laryngoscope 2011; 121:1620-6. [DOI: 10.1002/lary.21768] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
12
|
Reinforced laryngeal mask airway compared with endotracheal tube for adenotonsillectomies. Eur J Anaesthesiol 2011; 27:941-6. [PMID: 20739893 DOI: 10.1097/eja.0b013e32833d69c6] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The endotracheal tube (ETT) has traditionally been considered the best airway device during adenotonsillectomy because a well protected and secured airway is provided. This has been challenged by the introduction of the reinforced laryngeal mask airway (RLMA). It does not kink, is less traumatic during insertion and better tolerated during emergence. The purpose of this study was to compare the use of the RLMA with ETT with regards to postoperative pain, nausea, vomiting and perioperative efficacy in a series of children due for adenotonsillectomy. METHODS One hundred and thirty-four children, aged 3-16 years and scheduled for ambulatory adenotonsillectomies, were randomly assigned to two groups where the airways were secured with either the ETT (n = 62) or the RLMA (n = 69). We registered the incidence of peroperative and postoperative anaesthesiological complications and time consume, in addition to postoperative pain, nausea and overall satisfaction. RESULTS The Group RLMA scored significantly lower for maximal pain during the first 4 h postoperatively (P = 0.015). There were no significant differences in pain scores at 24 h or rescue pain medication postoperatively. The Group RLMA spent mean 4.2 min less in the operating room after surgery (P = 0.001). There were no significant differences in postoperative nausea. In those patients finally treated with ETT, including five conversions from RLMA, significantly more patients (10 vs. 2) had airway irritations (P < 0.02). CONCLUSION The RLMA, when feasible, is a well tolerated and effective alternative to the ETT for use during adenotonsillectomies in children, with beneficial effects on airway irritations, operating room efficiency and early postoperative pain.
Collapse
|
13
|
Abstract
The use of laryngeal mask airway (LMA) and its variants in ear, nose, and throat procedures have been extensively described in case reports, retrospective reviews, and randomized clinical trials. The LMA has developed a considerable following because of its lack of tracheal stimulation, which can be a considerable advantage in ear, nose, and throat (ENT) procedures. The incidence of coughing on emergence has been shown to be lower with the LMA than with the endotracheal tube (ETT). Although other approaches to smooth emergence have been described, few would argue that it is as easy to achieve a smooth emergence with an ETT as with an LMA. Although patients certainly exist for whom the LMA is contraindicated, many will experience better results with the LMA because of the features delineated in this article.
Collapse
Affiliation(s)
- Jeff E Mandel
- Department of Anesthesiology and Critical Care, University of Pennsylvania School of Medicine, Philadelphia, 19104, USA.
| |
Collapse
|
14
|
Gómez LM, Duque GR, Ocampo F, Gómez JC, Echeverri F. Seguridad y efectividad de la máscara laríngea en amigdalectomía y adenoidectomía:. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2009. [DOI: 10.1016/s0120-3347(09)74009-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
15
|
|
16
|
Militana CJ, Ditkoff MK, Mattucci KF. Use of the Laryngeal Mask Airway in Preventing Airway Fires during Adenoidectomies in Children: A Study of 25 Patients. EAR, NOSE & THROAT JOURNAL 2007. [DOI: 10.1177/014556130708601014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We report the results of our study of 25 children who underwent adenoidectomy under general anesthesia with a laryngeal mask airway to determine their risk of fire in the oropharynx. We explain the distinct advantage that such an anesthetic technique has with respect to minimizing the conditions that may contribute to an airway fire. We also discuss additional advantages of using a laryngeal mask airway during adenoidectomies.
Collapse
Affiliation(s)
- Charles J. Militana
- Department of Anesthesiology North Shore University Hospital, Manhasset, New York
| | - Michael K. Ditkoff
- Department of Otolaryngology North Shore University Hospital, Manhasset, New York
| | - Kenneth F. Mattucci
- Department of Otolaryngology North Shore University Hospital, Manhasset, New York
| |
Collapse
|
17
|
|
18
|
Michalek P, Scigel V, Kieslichova E, Rocen M. The Laryngeal Mask Airway (LMA) as an alternative to airway management in mentally retarded patients during dental procedures. SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2004. [DOI: 10.1080/22201173.2004.10872371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
19
|
Bishop P, Patel A. Laryngeal mask or tube for tonsillectomy? HOSPITAL MEDICINE (LONDON, ENGLAND : 1998) 2003; 64:440. [PMID: 12886861 DOI: 10.12968/hosp.2003.64.7.2288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Anaesthesia for ear, nose and throat (ENT) surgery poses a number of unique challenges for the anaesthetist. For many years airway management in ENT surgery required tracheal intubation. However, the advent of the laryngeal mask airway (LMA) provided anaesthetists with an alternative. So, LMA or tube for tonsillectomy?
Collapse
|
20
|
The laryngeal mask airway for outpatient otolaryngologic surgery. Curr Opin Otolaryngol Head Neck Surg 2000. [DOI: 10.1097/00020840-200006000-00016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
21
|
Presland AH, Evans AH, Bailey PM, Howard DJ. The laryngeal mask airway in tonsillectomy: the surgeon's perspective. CLINICAL OTOLARYNGOLOGY AND ALLIED SCIENCES 2000; 25:240. [PMID: 10944056 DOI: 10.1046/j.1365-2273.2000.00355.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|