Abstract
Aims & Objectives: Endotracheal tube is the gold standard of airway management, especially in major abdominal surgery. However it may cause a number of airway complications. The laryngeal mask may decrease such complications. The aim was to estimate safety of laryngeal mask and amount of complications in children underwent major elective abdominal surgery. Methods: We studied 201 children underwent major elective abdominal surgery under GA with mechanical ventilation. Mean age 6.3±3.5 years, weight - 25.4±5.1 kg. Surgery duration - 195.8±91.3 min. In 107 children used tracheal intubation (TI), in 94 patients the laryngeal mask (LM) was applied. During surgery we studied haemodynamics (MAP; HR) and gas exchange (PaO2, PaCO2, EtCO2). We studied gastric regurgitation rate in LM patients with methylene blue, and maximal peak pressure which causes gas leakage. After surgery we studied rate of airway complications. Results: No patients had gastric regurgitation. Mean airway pressure for leakage was 23.1±6.7 mbar. We didn’t find difference in gas exchange between groups. Hyperdynamic reaction to intubation/extubaton was greater in comparison with LM insertion/removal. Comparison of airway complications preponderated in TI group (Table): 25 vs 3 cases (p<0.05). - Complication TI group (n=107) LM group (n=94) Sore throat 23.4% 3.2% * Cough 14% 1.1% * Laryngospasm 1.9% 0 Airway infection 22.4% 1.1% * Nausea 7.5% 1.1% * Total 23.4% 3.2% * Conclusions: The laryngeal mask airway can provide safe and effective ventilation during major elective abdominal surgery in children. Laryngeal mask has minimal negative influence on haemodynamic parameters and reduces airway complications up to 7.3 times in comparison with tracheal intubation Keywords: laryngeal mask, airway complication, endotracheal tube, major surgery