Use of the Classic Laryngeal Mask Airway Versus an Endotracheal Tube in Children Undergoing Elective Surgery in the Prone Position: A Prospective Randomized Feasibility Study

Background: A laryngeal mask airway (LMA) has been used successfully during surgical procedures in the prone position for adults and children in some cases. In this study, we compared the use of a classic LMA versus an endotracheal tube (ETT) in children undergoing minor surgical procedures in the prone position. Patients and methods: Forty children aged 4-8 years with an American Society of Anesthesiologists' classification of I who were undergoing elective surgery in the prone position were assigned to an airway secured by an uncuffed ETT (n=20) and or an airway secured by an LMA (n=20). SpO2, end-tidal CO2, heart rate, and mean arterial blood pressure were recorded before and after insertion of the LMA or ETT. The numbers of insertion attempts using the ETT or LMA were documented, along with any complications. Results: The time taken to insert the ETT was longer than that taken to insert the LMA (15.35 ± 2.907 vs. 14.35 ± 1.843 s). No intraoperative laryngospasm was reported in either group. Bronchospasm occurred intraoperatively in 2 patients in the ETT group and in one patient in the LMA group. No device displacement was reported. Conclusions: The classic LMA and ETT were both used successfully in spontaneously breathing children undergoing surgical procedures in the prone position. However, LMA was associated with fewer intraoperative and postoperative complications.