Background: The removal of Laryngeal Mask Airway (LMA) in children may be associated with
respiratory adverse events. The incidence of these adverse events may be influenced by the
type of anesthesia maintenance. It is not clear whether Total Intravenous Anesthesia (TIVA)
with propofol is associated with a lower incidence of respiratory events upon removal of LMA
as compared to maintenance with sevoflurane.
Specific Aim: The primary aim of this study is to compare the prevalence of respiratory
adverse events following LMA removal in patient receiving TIVA versus sevoflurane
inhalational anesthesia in a pediatric population aged between 6 month and 6 years old.
Secondary outcomes include quality of induction, maintenance and emergence from anesthesia
between the 2 groups as evidenced by ease of LMA insertion, absence of bucking or movement
during the procedure, time to LMA removal, and absence of emergence agitation.
Methods: In this prospective randomized clinical trial, children will be enrolled in one of
two groups: Group 1 will receive propofol for induction and maintenance of anesthesia, Group
2 will receive sevoflurane for induction and maintenance of anesthesia. In both groups
patients will be mechanically ventilated. At the end of the procedure, LMAs will be removed
when patients are fully awake as defined by the return of reflexes, eye opening, and
purposeful movements.
Significance: Data comparing the influence of TIVA and sevoflurane on the occurrence of
respiratory adverse events after LMA removal are limited. Both techniques are standard of
care at our institution. However, as per our clinical observations, we hypothesize that TIVA
is superior to sevoflurane. This study will identify the technique that provides optimal
anesthetic conditions and improved patient's safety.