Presented as a poster at the American Society of Pediatric Otolaryngology Annual Meeting, Chicago, Illinois, U.S.A., April 28–May 1, 2011; and at the Lutheran General Research Consortium, Park Ridge, Illinois, U.S.A., May 5, 2011.
Article first published online: 17 JAN 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 2, pages 429–435, February 2012
How to Cite
Sierpina, D. I., Chaudhary, H., Walner, D. L., Villines, D., Schneider, K., Lowenthal, M. and Aronov, Y. (2012), Laryngeal mask airway versus endotracheal tube in pediatric adenotonsillectomy. The Laryngoscope, 122: 429–435. doi: 10.1002/lary.22458
Thirty LMA Flexible reinforced laryngeal mask airways were provided by LMA North America (San Diego, CA). The authors have no other funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 23 JAN 2012
- Article first published online: 17 JAN 2012
- Manuscript Accepted: 24 OCT 2011
- Manuscript Received: 29 AUG 2011
- Laryngeal mask airway;
- endotracheal tube;
- laryngeal mask;
- Level of Evidence: 1b
Evaluation of safety and postoperative outcomes of the laryngeal mask airway (LMA) during pediatric tonsil surgery compared to use of the endotracheal tube (ETT).
Randomized controlled trial.
A population-based sample of 117 patients ages 2 to 18 years requiring adenotonsillectomy, adenoidectomy, or tonsillectomy was studied. Evaluation forms covering 36 safety, surgery duration, and patient comfort variables were given to the surgeon, anesthesiologist, and phase I and phase II recovery nurses to collect data on the intra- and postoperative course. A phone survey was conducted 24 hours after surgery.
At the α level following Bonferroni correction, LMA showed less coughing or gagging during the anesthesia phase for all surgeries combined (48% for ETT vs. 20% for LMA; χ2 = 10.153, P = .002), and for ETT nontonsillectomy vs. LMA nontonsillectomy (48% for ETT vs. 3% for LMA; χ2 = 15.196, P = .000), spontaneous ventilation was used more often in the LMA group when comparing all surgeries (χ2 = 19.493, P = .000), and when comparing ETT tonsillectomy and LMA tonsillectomy (χ2 = 11.131, P = .000).
Use of the LMA during pediatric tonsil surgery does not appear to have any major disadvantages compared to use of the ETT. In fact, analysis of safety, comfort, complications, and postoperative problems suggests that LMA may be superior for some outcome variables such as coughing and gagging. Use of spontaneous ventilation is more common among LMA patients, although the significance of this finding is uncertain.