Laryngeal mask anesthesia during surgical treatment of pediatric patients with hydrocephalus

Objective: In hydrocephalic patients, peri-operative processes that reduce the risk of complications due to difficult intubation are essential. With this study, perioperative process evaluation of laryngeal mask and endotracheal intubation as an airway method in pediatric hydrocephalus patients is appropriately targeted for hydrocephalus patient management.Materials and methods: This retrospective study included patients diagnosed with hydrocephalus who underwent surgical treatment using a ventriculoperitoneal shunt. The study sample was divided two groups [endotracheal intubation (EI) and laryngeal mask (LMA)] based on the method of anesthesia administration. Results: The study included 81 patients with a mean age of 11.0±30.604 months. No significant differences in age, number of surgeries, body mass index, head circumference, incidence of laryngeal spasms, surgical duration, and volume of air leakage were observed between the groups. However, the duration of anesthesia (p=0.000), hospital and intensive care stay (p=0.007 and p=0.049, respectively), and airway establishment (p=0.049) were significantly shorter in the LMA group. Moreover, the number of attempts required for airway establishment was also low in this group (p=0.033).Conclusions: LMA, when used appropriately, can minimize the need for post-operative intensive care, shorten the length of hospital stay, enable early nutrition, and reduce the risk of hypothermia in pediatric patients with high risk of comorbidities. Moreover, this procedure can also potentially be life-saving during the peri-operative period, particularly in high-risk patients that are difficult to intubate and exhibit higher rates of comorbidities.