Randomized controlled trial comparing the laryngeal tube and the laryngeal mask in pediatric patients

  1. LUCIANO BORTONE MD1,
  2. PABLO M. INGELMO MD2,
  3. GESÙ DE NINNO MD1,
  4. MICHELA TOSI MD1,
  5. LAURA CAFFINI MD1,
  6. JUNA TRENCHI MD1,
  7. MARIO MERGONI MD1,
  8. FABIO MARTORANA MD2

Article first published online: 29 NOV 2005

DOI: 10.1111/j.1460-9592.2005.01756.x

Issue

Pediatric Anesthesia

Pediatric Anesthesia

Volume 16, Issue 3, pages 251–257, March 2006

Additional Information

How to Cite

BORTONE, L., INGELMO, P. M., NINNO, G. D., TOSI, M., CAFFINI, L., TRENCHI, J., MERGONI, M. and MARTORANA, F. (2006), Randomized controlled trial comparing the laryngeal tube and the laryngeal mask in pediatric patients. Pediatric Anesthesia, 16: 251–257. doi: 10.1111/j.1460-9592.2005.01756.x

Author Information

  1. 1

    Departments of Anaesthesia and Intensive Care, Azienda Ospedaliera di Parma, Parma

  2. 2

    Departments of Anaesthesia and Intensive Care, Ospedali Riuniti di Bergamo, Scuola di Anestesia e Rianimazione, Università degli Studi, Milano, Bicocca, Italy

*Luciano Bortone, Departments of Anaesthesia and Intensive care. Via Gramsci 14 (43100) Parma, Italy (email: lbortone@ao.pr.it).

Publication History

  1. Issue published online: 29 NOV 2005
  2. Article first published online: 29 NOV 2005
  3. Accepted 12 April 2005

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Keywords:

  • laryngeal mask airway;
  • laryngeal tube;
  • spontaneous ventilation;
  • assisted ventilation;
  • children;
  • fiberoptic evaluation

Summary

Background:  The laryngeal tube (LT) is a supraglottic ventilatory device used in adults. However, there is limited information about LT use in pediatric patients. This randomized controlled study compares LT with laryngeal mask (LMA) for airway management during spontaneous or assisted ventilation and during fiberoptic laryngoscopy in children.

Methods:  Thirty children under 10-years old, ASA I–II, scheduled for minor general surgery, Mallampati score I–II, fasted and premedicated were included. Patients with upper respiratory infection, craniofacial malformation, intracranial hypertension, emergency surgery were excluded. The primary outcome measure was the proportion of patients in whom effective spontaneous or assisted ventilation [Vt ≥ 4 ml·kg−1, SpO2 ≥ 95% with FiO2 0.4, PECO2≤7.2 kPa (55 mmHg)] was achieved after 3 min of LT or LMA cuff inflation. The secondary endpoint was the proportion of patients in whom fiberoptic laryngoscopy resulted in identification of the vocal cords.

Results:  Eleven children with LMA and two children in LT group had adequate spontaneous or assisted ventilation after initial positioning (P < 0.01). After head extension or device repositioning 15 of 15 patients in LMA group had adequate ventilation compared with 11 of 15 patients in LT group (P < 0.05). The vocal cords could be observed with fiberoptic laryngoscopy in 11 LMA group patients compared with no patients in the LT group (P < 0.001).

Conclusions:  The LT is less effective than the LMA to allow adequate spontaneous or assisted ventilation and for fiberoptic evaluation of the airway in children under 10 years old.

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