Use of the laryngeal mask airway during ophthalmic surgery results in stable circulation and few complications: A prospective audit

Background: This study was performed to investigate airway complications related to Laryngeal Mask Airway (LMA) use in a selected group of paediatric patients undergoing ophthalmic surgery. Methods: Ninety-four paediatric patients were enrolled. LMA was inserted under deep general anaesthesia with the standard technique previously described by Brain. Complications during induction, insertion of the LMA, maintenance of anaesthesia, removal of the LMA, emergence and on the first postoperative day were recorded. Failure of insertion, desaturation, laryngospasm, bronchospasm, vomiting, bucking, dislocation of the LMA, breath-holding, and coughing were noted. Results: There was no significant age-related difference in successful insertion ratio of the LMA. In two patients (2%), the LMA could not be inserted with three attempts and tracheal intubation was performed. Laryngospasm was recorded in three patients (3%), leading to desaturation in two patients (SaO₂<95%) during insertion of the LMA. During maintenance of anaesthesia bucking occurred in one patient (1%). After removal of the LMA, incidence of early desaturation following upper airway suctioning was higher in patients with a history of frequent upper respiratory tract infection (P<0.01). Five patients (5%) had laryngospasm following the LMA removal; breath-holding and coughing were noted in 21 (22%) patients. Circulatory reactions to insertion and removal of the LMA were minimal. The incidence of sore throat on the first postoperative day was only 1%. Conclusion: LMA can be regarded as a safe product for airway maintenance during ophthalmic surgery with a stable circulation and few complications.