Use of LMAs in strabismus surgery in children age 1-12
A three-year audit on 276 children undergoing ambulatory strabismus repair.
Andreas H Taenzer, MD FAAP, Department of Anesthesiology, Maine Medical Center, Portland, ME

Introduction
Although the use of LMAs in children is widespread, there is some reluctance in using them if the airway is not accessible or manipulation would interrupt the flow of surgery.
We report our experience with the use of LMAs in children undergoing strabismus repair.
Methods
As part of an ongoing Quality Assurance project we retrospectively reviewed prospectively gathered data regarding the safety of LMA use in children undergoing strabismus surgery.
From 9/01 to 8/04 276 children between 1 - 12 were included in the analysis.
20 charts were randomly pulled to check for data accuracy, no mistakes were found.
All of the charts of patients who had an ETT were reviewed.
Results
Of the 276 children, 4 (1.2 %) were managed electively with an endotracheal tube, 272 (98.6%) with an LMA.

• There were no conversions from ETT to LMA.
• No oxygen desaturations < 90% were recorded.
• No interruptions of surgery because of airway difficulties are known.

Discussion
At last years SAMBA meeting we reported our experience with postoperative vomiting (4.2% in the first 24 hours) after ambulatory strabismus surgery (”Incidence of POV after ambulatory strabismus surgery in children”, SAMBA 2004). The most common question we received addressed the safety of routine use of LMAs with this kind of surgery.
We conclude that the use of LMAs in pediatric strabismus surgery is safe and does not increase the risk of interrupting surgery for airway problems.

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