Ventilation with the laryngeal tube in pediatric patients undergoing elective ambulatory surgery

Background: The laryngeal tube is a new supraglottic alternative for securing the airway. Few data on the use of this airway device in pediatric patients are so far available. Experiences of the study are reported. Methods: Use of the laryngeal tube for ventilation during intermittent positive-pressure ventilation was studied in an open, noncomparative observational study in 80 pediatric patients (age: 2-12 years) undergoing elective ambulatory surgery. Insertion success, time to achieve a patent airway, and occurrence of adverse events were documented. Results: Mean (sd) patient age was 5.8 (2.3) years. The laryngeal tube was placed at the first attempt in 90% of patients, a second attempt was necessary in 6%. Ventilation was not possible after two attempts in three patients. Mean (sd) tidal volume was 10.1 (2.0) ml.kg(-1) with a mean (sd) peak airway pressure of 15.6 (2.1) cmH(2)O. Chin lift was applied to improve ventilation in 15 patients (18.8%). Laryngospasm occurred in one patient, but ventilation was possible after adapting depth of anesthesia. Mean (sd) time for airway maintenance was 11.2 (3.7) s. No gastric insufflation of air occurred, no traces of blood could be detected after removal of the device. One patient complained of mild problems (swallowing, VAS 1). Mean (sd) anesthesia time was 44 (9) min. Conclusions: In the age group studied, the laryngeal tube provides a rapid, patent airway in the majority of patients with a low complication rate.