The Laryngeal Mask Airway: Is It Safe for Pediatric Adenotonsillectomy?
Tonsillectomy with or without adenoidectomy (T&A) is one of the most common pediatric surgical procedures performed in the United States. Traditionally an endotracheal tube is used to secure the airway in these cases. However, the laryngeal mask airway (LMA) is also being used for pediatric T&As. This review explores the question: In pediatric patients undergoing tonsillectomy with or without adenoidectomy, does the laryngeal mask airway compared to the endotracheal tube provide a safe and effective means of airway management?
While all evidence sourcesconcluded it was possible to use an LMA for pediatric T&A, not all of the investigators fully supported its use in this setting. The authors of six of the seven evidence sources determined that the LMA was an overall safe and viable alternative for this procedure, but one of the RCTs indicated the issues with kinking and visualization and called for further study.
Future investigation should compare different types of laryngeal mask airways to determine superiority in terms of surgical access, visualization,and reduced displacement or kinking with insertion of the mouth gag.
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