Pi Phi Chapter

Safety of Using a Laryngeal Mask Airway in Pediatric Patients Undergoing Adenotonsillectomy

Nursing Research on the Green

2011 Abstract

Mary Dudley CRNA, MS
Ana Schaper PhD, RN; Jenna Hanson BSN; Chelsea McMorrow BSN
Gundersen Lutheran Health System

Research 

  • Background: Adenotonsillectomy (T&A) is one of the most common surgical procedures performed in children in the U.S. Since 1983, laryngeal mask airway (LMA)anesthesia has been utilized for T&A as an alternative to endotracheal intubation (ETT). The LMA has proven to be a safe and effective technique for airway management. However, little research on LMA has been conducted on populations with in the U.S.
  • Significance: Advantages to the LMA include: increased ease and speed of placement by less experienced personnel, improved hemodynamic stability during induction and emergence, lower incidence of coughing and sore throat, improved oxygen saturation, and reduced anesthetic requirements for airway tolerance.
  • Purpose/objective: To describe the safety for using the LMA in a community sample of children and adolescents.
  • Methods/project: A retrospective chart review was conducted for 100 pediatric patients who underwent a T&A at Gundersen Lutheran during a three-year time period.
  • Results: Hypertrophy was the most common implication for surgery. Sleep disordered breathing was the second most common implication for surgery at 84%. Only 1% of the patients in our study were converted from a LMA to ETT and only 5% of patients required a hospital admission. Reasons for hospital admission included: dehydration, post-operative rebleeding, and significant sleep apnea.
  • Clinical Implications: The LMA is a valid method to use with similar event rates to the ETT.

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