Safety of removal of ProSeal laryngeal mask airway in children in the supine versus lateral position in a deep plane of anesthesia: A randomized controlled trial
ABSTRACT Importance When a ProSeal laryngeal mask airway (PLMA) is removed with the child in a deep plane of anesthesia, the upper airway muscle tone and protective upper airway reflexes may be obtunded. Objective To determine whether the supine or lateral position is safer for the removal of a PLMA...
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| Format: | Article |
| Language: | English |
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Wiley
2023-12-01
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| Series: | Pediatric Investigation |
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| Online Access: | https://doi.org/10.1002/ped4.12401 |
| _version_ | 1797422292816363520 |
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| author | Shweta Dhiman Anju R. Bhalotra Kavita R. Sharma |
| author_facet | Shweta Dhiman Anju R. Bhalotra Kavita R. Sharma |
| author_sort | Shweta Dhiman |
| collection | DOAJ |
| description | ABSTRACT Importance When a ProSeal laryngeal mask airway (PLMA) is removed with the child in a deep plane of anesthesia, the upper airway muscle tone and protective upper airway reflexes may be obtunded. Objective To determine whether the supine or lateral position is safer for the removal of a PLMA in deeply anesthetized children by comparing the incidence of upper airway complications. Methods This randomized single‐blind comparative trial was conducted at a tertiary care hospital between January 2020 and September 2020. Forty children of the American Society of Anesthesiologists class I/II of ages 1–12 years age undergoing surgery under general anesthesia with PLMA used as the definitive airway device were recruited. Patients were randomly allocated to lateral group or supine group for PLMA removal in a deep plane of anesthesia in the lateral or supine position. The primary outcome was the number of patients experiencing one or more upper airway complications and the secondary outcomes were incidence of individual respiratory adverse effects and of severe airway complications. Results The incidence of airway complications was 30% in the supine group and 20% in the lateral group (P = 0.6641). Incidence of laryngospasm, immediate stridor, and excessive secretions were similar. Early stridor and oxygen desaturation were higher in the supine group (P = 0.0374, P = 0.0183 respectively). Interpretation The overall incidence of upper airway complications was similar with the removal of a PLMA in the supine or lateral position in deeply anesthetized children. The incidence of oxygen desaturation and stridor were higher with PLMA removal in the supine as compared to the lateral position. |
| first_indexed | 2024-03-09T07:30:05Z |
| format | Article |
| id | doaj.art-43f84319ec234d348b821622d411551a |
| institution | Directory Open Access Journal |
| issn | 2574-2272 |
| language | English |
| last_indexed | 2024-03-09T07:30:05Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pediatric Investigation |
| spelling | doaj.art-43f84319ec234d348b821622d411551a2023-12-03T06:24:55ZengWileyPediatric Investigation2574-22722023-12-017423323810.1002/ped4.12401Safety of removal of ProSeal laryngeal mask airway in children in the supine versus lateral position in a deep plane of anesthesia: A randomized controlled trialShweta Dhiman0Anju R. Bhalotra1Kavita R. Sharma2Department of Anaesthesiology and Intensive Care Maulana Azad Medical College and Associated Hospitals New Delhi IndiaDepartment of Anaesthesiology and Intensive Care Maulana Azad Medical College and Associated Hospitals New Delhi IndiaDepartment of Anaesthesiology Vardhaman Mahavir Medical College and Safdarjung Hospital New Delhi IndiaABSTRACT Importance When a ProSeal laryngeal mask airway (PLMA) is removed with the child in a deep plane of anesthesia, the upper airway muscle tone and protective upper airway reflexes may be obtunded. Objective To determine whether the supine or lateral position is safer for the removal of a PLMA in deeply anesthetized children by comparing the incidence of upper airway complications. Methods This randomized single‐blind comparative trial was conducted at a tertiary care hospital between January 2020 and September 2020. Forty children of the American Society of Anesthesiologists class I/II of ages 1–12 years age undergoing surgery under general anesthesia with PLMA used as the definitive airway device were recruited. Patients were randomly allocated to lateral group or supine group for PLMA removal in a deep plane of anesthesia in the lateral or supine position. The primary outcome was the number of patients experiencing one or more upper airway complications and the secondary outcomes were incidence of individual respiratory adverse effects and of severe airway complications. Results The incidence of airway complications was 30% in the supine group and 20% in the lateral group (P = 0.6641). Incidence of laryngospasm, immediate stridor, and excessive secretions were similar. Early stridor and oxygen desaturation were higher in the supine group (P = 0.0374, P = 0.0183 respectively). Interpretation The overall incidence of upper airway complications was similar with the removal of a PLMA in the supine or lateral position in deeply anesthetized children. The incidence of oxygen desaturation and stridor were higher with PLMA removal in the supine as compared to the lateral position.https://doi.org/10.1002/ped4.12401Airway managementGeneral anesthesiaLaryngeal masksPediatrics |
| spellingShingle | Shweta Dhiman Anju R. Bhalotra Kavita R. Sharma Safety of removal of ProSeal laryngeal mask airway in children in the supine versus lateral position in a deep plane of anesthesia: A randomized controlled trial Pediatric Investigation Airway management General anesthesia Laryngeal masks Pediatrics |
| title | Safety of removal of ProSeal laryngeal mask airway in children in the supine versus lateral position in a deep plane of anesthesia: A randomized controlled trial |
| title_full | Safety of removal of ProSeal laryngeal mask airway in children in the supine versus lateral position in a deep plane of anesthesia: A randomized controlled trial |
| title_fullStr | Safety of removal of ProSeal laryngeal mask airway in children in the supine versus lateral position in a deep plane of anesthesia: A randomized controlled trial |
| title_full_unstemmed | Safety of removal of ProSeal laryngeal mask airway in children in the supine versus lateral position in a deep plane of anesthesia: A randomized controlled trial |
| title_short | Safety of removal of ProSeal laryngeal mask airway in children in the supine versus lateral position in a deep plane of anesthesia: A randomized controlled trial |
| title_sort | safety of removal of proseal laryngeal mask airway in children in the supine versus lateral position in a deep plane of anesthesia a randomized controlled trial |
| topic | Airway management General anesthesia Laryngeal masks Pediatrics |
| url | https://doi.org/10.1002/ped4.12401 |
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