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.

This study is a systematic review and meta-analysis on the association between perioperative respiratory adverse events and airway devices. The study only includes randomized controlled trials for analysis. Only four trials were able to be included in the final analysis, which highlights the lack of good studies on this topic. Due to the paucity of qualifying trials, only LMA and ETT use were compared. Facemask only use was excluded.
The meta-analysis found no statistical difference in the incidence of apnoea, oxygen desaturation, breath holding or laryngospasm between the use of LMA or ETT. There was a decrease in the incidence of cough using an LMA. The study found no evidence to support a reduction in perioperative respiratory events associated with the use of LMA.
Take Home Message / Commentary
The paper makes a good literature review of the topic. The results of this study suggest that there is no advantage in choosing an LMA over an ETT to prevent adverse respiratory events in a child with a respiratory tract infection.
This study highlights the lack of good evidence on this topic whilst acknowledging the difficulties in gaining evidence when current practice recommends delaying elective surgery in the presence of a respiratory tract infection.

Reviewed by: Dr K. McGregor