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Removal of the laryngeal tube in children: anaesthetized compared with awake

Cited 2 time in Web of Science Cited 5 time in Scopus
Authors
Lee, J.; Kim, J.; Kim, S.; Kim, C.; Yoon, T.; Kim, H.
Issue Date
2007-04-10
Publisher
Oxford University Press
Citation
Br J Anaesth. 2007 Jun;98(6):802-5. Epub 2007 Apr 7.
Keywords
Airway Obstruction/*etiology/prevention & controlAnesthesia, Inhalation/*methodsAnesthetics, InhalationAwarenessChildChild, PreschoolCough/etiology/prevention & controlDevice Removal/*adverse effects/methodsFemaleHumansInfant*Laryngeal MasksMaleMethyl EthersPostoperative Nausea and Vomiting/etiology/prevention & controlSialorrhea/etiology/prevention & control
Abstract
BACKGROUND: Laryngeal tube (LT) is a useful airway device in children, but there is no objective evidence that removal of LT in awake state is better than in anaesthetized state. So, we compared the incidence of respiratory adverse events after the removal of LT, either under anaesthesia or on awakening. METHODS: Seventy healthy children between 1 and 12 yr of age were enrolled in this study. Anaesthesia was induced and maintained with sevoflurane. After induction of anaesthesia, patients were randomized into two groups: removal of LT in anaesthetized state (Group A: 2% sevoflurane) and in awake state (Group B). During and within 1 min of the removal of LT, airway complications such as upper airway obstruction, cough, vomiting, teeth clenching, hypersalivation, desaturation <90%, and laryngospasm were recorded. RESULTS: Cough (37.1 vs 2.9%), hypersalivation (28.6 vs 5.7%), desaturation (20 vs 0%), and LT dislocation during emergence relating to the patient's movement (26.5 vs 0%) occurred more frequently in Group B (P < 0.05). Upper airway obstruction occurred more frequently (68.6 vs 31.4%) in Group A, and it was easily resolved by chin or jaw lifting. CONCLUSION: LT removal in anaesthetized state reduced cough, hypersalivation, and prevented tube displacement and hypoxia. Upper airway obstruction in the anaesthetized state should be predicted and managed with chin or jaw lifting.
ISSN
0007-0912 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17416908

http://hdl.handle.net/10371/22923
DOI
https://doi.org/10.1093/bja/aem070
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College of Medicine/School of Medicine (의과대학/대학원)Anesthesiology and Pain Medicine (마취통증의학전공)Journal Papers (저널논문_마취통증의학전공)
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