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KMID : 0878620010050020074
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Korean Journal of Pediatric Anesthesia
2001 Volume.5 No. 2 p.74 ~ p.78
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The Efficacy of Mechanical Ventilation with a Laryngeal Mask Airway in Children
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Chung Chan-Jong
Lee Do-Kyung
Yang Geu-Jeung
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Abstract
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Background: We evaluated the efficacy and safety of mechanical ventilation with a laryngeal mask airway (LMA) in paralyzed children, compared with an endotracheal tube (ETT).
Methods: Children aged 2∼7 years, undergoing strabismus surgery, were randomly assigned to two groups for ETT or LMA insertion. Anesthesia was induced with propofol 2㎎/㎏ and maintained with a continuous infusion of propofol 6∼10㎎/㎏/h in 67% N2O. An ETT or LMA was placed with atracurium 0.5㎎/㎏. Ventilation was controlled to maintain endtidal CO2 partial pressure PETCO2) between 30∼40㎜Hg. Leak pressure, peak inspiratory pressure, compliance of respiratory system, expiratory tidal volume, oxygen saturation (SaO2) and PETCO2 were recorded. Epigastric circumference (EC) and umbilical circumference (UC) were measured before and after positive pressure ventilation with a mechanical ventiator.
Results: In both groups the SaO2 stayed above 98% and PETCO2 between 32∼40㎜Hg during the entire study. Peak inspiratory pressure, expiratory tidal volume and compliance of the respiratory system did not differ between groups. Percent changes in EC (1.5±1.7% vs. 1.6±1.6%) and UC (0.9±1.3% vs. 1.3±1.1%) did not differ between the ETT and LMA groups.
Conclusions: Mechanical ventilation can be safely and effectively performed with a size 2 or 2.5 LMA without gastric distension in paralyzed children.
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KEYWORD
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Equipment: endotracheal tube, laryngeal mask airway, Technique: mechanical ventilation
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