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Randomized Controlled Trial
. 2021 Jan 8;21(1):10.
doi: 10.1186/s12871-021-01235-7.

The impact of topical lidocaine and timing of LMA removal on the incidence of airway events during the recovery period in children: a randomized controlled trial

Ruiqiang Sun  1 , Xiaoyun Bao  2 , Xuesong Gao  3 , Tong Li  3 , Quan Wang  3 , Yueping Li  3
Affiliations
Randomized Controlled Trial

The impact of topical lidocaine and timing of LMA removal on the incidence of airway events during the recovery period in children: a randomized controlled trial

Ruiqiang Sun et al. BMC Anesthesiol. .

Abstract

Background: The timing of laryngeal mask airway (LMA) removal remains undefined. This study aimed to assess the optimal timing for LMA removal and whether topical anesthesia with lidocaine could reduce airway adverse events.

Methods: This randomized controlled trial assessed one-to-six-year-old children with ASA I-II scheduled for squint correction surgery under general anesthesia. The children were randomized into the LA (lidocaine cream smeared to the cuff of the LMA before insertion, with mask removal in the awake state), LD (lidocaine application and LMA removal under deep anesthesia), NLA (hydrosoluble lubricant application and LMA removal in the awake state) and NLD (hydrosoluble lubricant application and LMA removal in deep anesthesia) groups. The primary endpoint was a composite of irritating cough, laryngeal spasm, SpO2 < 96%, and glossocoma in the recovery period in the PACU. The secondary endpoints included the incidence of pharyngalgia and hoarseness within 24 h after the operation, duration of PACU stay, and incidence of agitation in the recovery period. The assessor was unblinded.

Results: Each group included 98 children. The overall incidence of adverse airway events was significantly lower in the LA group (9.4%) compared with the LD (23.7%), NLA (32.6%), and NLD (28.7%) groups (P=0.001). Cough and laryngeal spasm rates were significantly higher in the NLA group (20.0 and 9.5%, respectively) than the LA (5.2 and 0%, respectively), LD (4.1 and 1.0%, respectively), and NLD (9.6 and 2.1%, respectively) groups (P=0.001). Glossocoma incidence was significantly lower in the LA and NLA groups (0%) than in the LD (19.6%) and NLD (20.2%) groups (P< 0.001). At 24 h post-operation, pharyngalgia incidence was significantly higher in the NLA group (15.8%) than the LA (3.1%), LD (1.0%), and NLD (3.2%) groups (P< 0.001).

Conclusions: LMA removal in the awake state after topical lidocaine anesthesia reduces the incidence of postoperative airway events.

Trial registration: ChiCTR, ChiCTR-IPR-17012347 . Registered August 12, 2017.

Keywords: Airway events; Child; General anesthesia; Laryngeal masks; Lidocaine.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study flowchart. LA group: lidocaine cream smeared to the cuff of the laryngeal mask airway (LMA) before insertion, with mask removal in the awake state. LD group: lidocaine application and LMA removal under deep anesthesia. NLA group: hydrosoluble lubricant application and LMA removal in the awake state. NLD group: hydrosoluble lubricant application and LMA removal in deep anesthesia
See this image and copyright information in PMC

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References

    1. Beleña JM, Ochoa EJ, Núñez M, Gilsanz C, Vidal A. Role of laryngeal mask airway in laparoscopic cholecystectomy. World J Gastrointest Surg. 2015;7:319–325. doi: 10.4240/wjgs.v7.i11.319. - DOI - PMC - PubMed
    1. de Carvalho ALR, Vital RB, de Lira CCS, Magro IB, Sato PTS, Lima LHN, Braz LG, Módolo NSP. Laryngeal Mask Airway Versus Other Airway Devices for Anesthesia in Children With an Upper Respiratory Tract Infection: A Systematic Review and Meta-analysis of Respiratory Complications. Anesth Analg. 2018;127:941–950. doi: 10.1213/ANE.0000000000003674. - DOI - PubMed
    1. Simon LV, Torp KD. Laryngeal Mask Airway. 2019 Nov 25. StatPearls. Treasure Island: StatPearls Publishing; 2020. - PubMed
    1. Li L, Zhang Z, Yao Z, Wang H, Wang H, An H, Yao J. The impact of laryngeal mask versus other airways on perioperative respiratory adverse events in children: A systematic review and meta-analysis of randomized controlled trials. Int J Surg. 2019;64:40–48. doi: 10.1016/j.ijsu.2019.02.020. - DOI - PubMed
    1. van Esch BF, Stegeman I, Smit AL. Comparison of laryngeal mask airway vs tracheal intubation: a systematic review on airway complications. J Clin Anesth. 2017;36:142–150. doi: 10.1016/j.jclinane.2016.10.004. - DOI - PubMed

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