Maintenance of airway patency with a laryngeal mask and COPA-airway during small surgical interventionin children.

Abstract

ntroduction The most common methods for maintaining a free airway during anesthesia in children are the traditional airway without a cuff, COPA - airway, laryngeal mask airway and endotracheal tube. In contrast to the main methods of maintaining the airway, the LMA and COPA-airway be- gan to be widely used relatively recently. Therefore, one of the main tasks of our work was to assess the compara- tive effectiveness and safety, to determine the advantages and disadvantages, to develop recommendations for their use. Material and methods Depending on the type of airway control, patients were randomized into 3 groups: (n = 66) - children with an en- dotracheal tube, (n = 26) - children with a laryngeal mask (LMA), (n = 67) - children with COPA airway. The in- stallation of LMA and COPA - airway we carried out only after reaching the surgical stage of anesthesia, when the laryngeal and pharyngeal reflexes disappeared. Results a study conducted on this issue shows that LMA, COPA- airway and endotracheal intubation are effective and safe means of maintaining the free flow of the respiratory tract in children with general anesthesia. The main differences between them are only in the degree of protection of the respiratory tract from aspiration, simplicity and invasive- ness of the method, and convenience and comfort for the anesthesiologist. Compared with endotracheal intubation with a cuffed tube, when the child’s airway is as tight as possible and protected, when using LMA and COPA- airway, the risk of aspiration is not excluded and the probability of gas leakage increases. When using LMA and COPA-airway there is a time limit for the duration of the operation. They can be used only for short and me- dium duration operations. Conclusions Laryngeal mask and COPA-airway are a new concept of airway management. Compared with a face mask and a conventional duct, LMA and COPA-airway provide greater tightness between the upper respiratory tract and anesthesia apparatus, allow you to safely manage anes- thesia “at a distance” reduce the release of gaseous anes- thetics to the environment.

Keywords

• lma