Laryngeal Mask Airway versus Endotracheal Intubation for Adenoidectomy in Outpatient Surgery – Single Center Experience

Abstract

Adenoidectomy with or without tonsillectomy remains one of the most routinely performed surgical procedures in children. The duration of the procedure is usually less than half an hour and is done in a day surgery setting. Airway management for adenoidectomy can be especially challenging as the airway is shared between the surgeon and the anesthesiologist. The gold standard for airway management is an endotracheal tube (ETT), even though there has been an increase in the use of laryngeal mask airway (LMA) over the past decade. This retrospective study investigated patient data collected over a 4-year period (2016 to 2020). Data included 210 cases in a day surgery setting. We analyzed the choice of airway device and use of neuromuscular blockers and analgesics for pain management. The use of LMA was noted in 67.62% while endotracheal intubation was performed in 32.38% of cases. LMA resulted in fewer respiratory complications compared to ETT (p=0.006). The need for neuromuscular blockers was also lower in the LMA group (p=0.01). There was no statistically significant difference in the intraoperative dose of opioid analgesia (p=0.09). Flexible LMA is a satisfactory alternative to endotracheal intubation for outpatient pediatric adenoidectomy.

Keywords

• Endotracheal tube
• Laryngeal mask airway
• Adenoidectomy