Comparison of Incidence of Laryngospasm Between Laryngeal Mask Airway and Endotracheal Tube During Recovery Phase Following Urological Procedure in Pediatric

Abstract

Background: Laryngospasm is a critical perioperative complication in pediatric anesthesia, particularly during the recovery phase following urological procedures. The choice of airway device—laryngeal mask airway (LMA) versus endotracheal tube (ETT)—may influence both the incidence and severity of laryngospasm, yet data specific to pediatric urological populations remain limited. Objective: To compare the incidence and severity of laryngospasm between LMA and ETT in pediatric patients undergoing elective urological procedures, and to assess the impact of age and ASA Physical Status (ASA PS) on laryngospasm occurrence. Methods: In this descriptive cross-sectional study, 120 pediatric patients (ages 1–18 years) undergoing elective urological surgery under general anesthesia were prospectively enrolled at two tertiary care hospitals. Participants were assigned to LMA (n=60) or ETT (n=60) groups based on clinical judgment. Laryngospasm occurrence, severity, timing, and management were recorded. Statistical analyses included chi-square tests, Mann-Whitney U tests, and Spearman’s correlation; significance was set at p<0.05. Results: Laryngospasm occurred in 8.3% of the LMA group and 21.7% of the ETT group (p=0.041; OR=0.33, 95% CI: 0.11–0.98). However, severe laryngospasm episodes were proportionally higher in the LMA group. Age and ASA PS showed no significant correlation with laryngospasm incidence. ETT use was associated with more frequent respiratory complications and postoperative management needs. Conclusion: LMA use significantly reduces the incidence of laryngospasm compared to ETT in pediatric urological surgery, though episodes with LMA may be more severe. Vigilant perioperative monitoring and tailored airway management are warranted to optimize safety.