Identification of laryngeal mask airway failure in pediatric patients: a pilot study

Aims: The study was conducted to identify predictors of LMA placement failure in pediatric patients and to investigate the relationship between LMA placement failure and postoperative airway complications. Methods: This study was designed as a prospective observational trial including 66 ASA I patients aged 2-12 years who were scheduled for elective surgery. The patients were divided into two groups based on the placement of the LMA: Group S (successful placement of LMA at first attempt) and Group non-S (non-successful placement of LMA at first attempt). The relationship between LMA placement failure with airway leakage, peak airway pressure, peripheral oxygen saturation, and expiratory CO2 measurements was evaluated. Results: Airway leakage and peak airway pressure was significantly higher in Group non-S when compared to Group S [median (IQR) (mL); 10 (4) vs. 5 (5); p <0.001] and [median (IQR) (cm-H2O); 14 (3.5) vs.13 (2); p = 0.038], respectively. Patients in Group non-S exhibited a higher incidence of postoperative respiratory complications when compared to Group S (72.4% vs 27.6%; p <0.001). Conclusion: Airway leak and peak airway pressure can serve as determinants of LMA failure in pediatric patients.