Comprehensive Summary
In their study, Katzenchlager et al. (2024) conducted a single-center, randomized controlled trial in Germany comparing the efficacy of pediatric laryngeal tubes and laryngeal masks during elective surgery. Researchers looked at patient data from 196 children - 135 of which were randomized and analyzed per protocol - with 61 receiving a laryngeal tube and 74 receiving a laryngeal mask. Primary outcomes included insertion time and first-attempt success, with secondary measures of airway leak pressure and perioperative complications. Overall, the laryngeal mask demonstrated superior performance as there was a significantly lower insertion time (31s vs. 37) and markedly, a significantly higher first-attempt success rate (90.5% vs 45.9%). Overall placement success was also greater with the laryngeal mask (97.3% vs 45.9%). The differences in airway leakage were considered not clinically significant, reinforcing the overall advantage of the laryngeal mask in comparison to the laryngeal tube.
Outcomes and Implications
Supraglottic airway devices (SADs) are vital tools that provide an alternative to tracheal intubation and can enable rapid, less invasive airway management.. The laryngeal tubes and masks that were used in this study fall under the category of SADs, a category of airway devices with mixed evidence regarding optimal pediatric use. Rigorous comparison of these devices informs strategies to optimize pediatric airway management and potentially improve perioperative outcomes. Because airway interventions can be especially challenging in young children, identifying devices that reduce procedure time and discomfort is clinically important. While larger multicentre trials are needed for confirmation, these findings suggest that the laryngeal mask may be the preferred supraglottic airway for pediatric elective surgery.