Laryngeal mask versus endotracheal tube in adenectomies of children – a retrospective analysis of 1500 operations

Introduction:

Adenectomy is among the most frequently conducted surgical procedures in head and neck surgery and in pediatric patients in general. Because it is a fast surgical procedure, anesthesiologists prefer the use of laryngeal masks for anesthesia rather than endotracheal tubes, proposing the former to be more secure and to speed up the changing times between operations. The aim of the current study is to compare the use of laryngeal masks versus endotracheal tubes in adenectomies of children.

Methods:

1800 children undergoing adenectomies at our institution between 2009 and 2017 were included. Until 2012, all operations were conducted with an endotracheal tube, whereas in operations from 2013 on laryngeal masks were used for anesthesia. An analysis of operation times (time until start of surgery, surgery itself, exit of operation theatre), intra- or post-operative complications as well as the need to change intraoperatively from laryngeal mask to endotracheal tube was performed.

Results:

The use of a laryngeal mask prolonged the time needed for surgery as well as the exit of the operation theatre, whereas the time until start of surgery did not differ. With laryngeal masks, however, there was a higher amount of intra- or post-operative laryngeal spasms or loss of oxygenation compared to endotracheal tubes. Moreover, in 15% of the operations with laryngeal masks a switch to an endotracheal tube became necessary due to complications.

Conclusions:

In this series of adenectomies the use of laryngeal masks increased the rate of intra- and post-operative complications as well as the time needed for operations. We therefore postulate that laryngeal masks are not the anesthesiological strategy of choice in adenectomies of children.

Publication History

Publication Date:
18 April 2018 (online)