Use of Laryngeal Mask Airway and Its Removal in a Deeply Anaesthetized State Reduces Emergence Agitation after Sevoflurane Anaesthesia in Children

This study investigated the effect of laryngeal mask airway (LMA) and removal while in a deeply anaesthetized state (deep removal) compared with endotracheal tube and extubation when awake or deeply anaesthetized on the incidence of emergence agitation in children after sevoflurane anaesthesia for subumbilical surgery. Patients (2 - 7 years) were randomly assigned to one of three groups: ET-A group (n = 56, endotracheal tube and extubation whilst awake); ET-D group (n = 56, endotracheal tube and deep extu bation); LMA-D group (n = 56, experienced LMA and deep removal). The incidence of postoperative emergence agitation was significantly lower in the LMA-D patients compared with patients in the ET-A group (21.4% and 41.1%, respectively). Patients in the LMA-D group required a significantly shorter stay in the postanaesthetic care unit (PACU) than ET-A patients. There were no significant differences in the incidence of postoperative emergence agitation or length of stay in the PACU between the ET-A and ET-D groups, or between the ET-D and LMA-D groups. In conclusion, using an LMA and deep removal decreased postoperative emergence agitation compared with using an endotracheal tube and awake extubation after paediatric sevoflurane anaesthesia.