NIHR Signal: Infants anaesthetised without placing a tube in the trachea have fewer adverse breathing events

Published on 11 July 2017

Adverse breathing events are about three times more common when using endotracheal tubes than laryngeal mask airways for infants under 12 months receiving non-urgent surgery.

Airway problems are common during anaesthesia in children, accounting for three quarters of critical incidents and a third of cardiac arrests. They are more frequent in younger children, especially infants under 12 months, who have smaller airways and rapidly use up their oxygen reserves.

Laryngeal mask airways have been used in adults and older children for over 35 years for minor and intermediate surgery. Many studies have shown them to have fewer airway-related complications than tubes. This Australian randomised controlled trial supported this, finding an adverse event rate of 53% with endotracheal tubes compared with only 18% with laryngeal mask airways.

Conventional anaesthesia teaching advises the use of endotracheal tubes in infants even for relatively minor surgery, to provide a secure airway, but incidents may be more common when placing or removing the tube than a laryngeal mask.

Link to article here

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