# The Use of Laryngeal Mask Airway Versus Endotracheal Intubation in Pediatric Laparoscopic Inguinal Hernia Repair: A Randomized Controlled Trial — GCMD Library

<i>Emily L. Weisberg, Benjamin J. Pieters, Meredith S. Elman, Cory J. Nonnemacher, Janelle Noel-MacDonnell, Tolulope A. Oyetunji</i><div><b><br></b></div><div><b>Background
</b></div><div>A laryngeal mask airway (LMA) is routinely used for many types of pediatric surgical procedures and as a rescue airway device. Laparoscopic procedures in pediatric surgery are common and are becoming increasingly widespread. In laparoscopic surgery, the traditional airway approach is the use of endotracheal intubation, while the use of LMA in laparoscopic surgery is not well studied.
</div><div><br></div><div><b>Aims
</b></div><div>To evaluate the effectiveness of general anesthesia with LMA versus traditional endotracheal tube (ETT) for pediatric patients aged 12 months to 8 years old undergoing laparoscopic inguinal hernia repair.
</div><div><br></div><div><b>Methods
</b></div><div>In a single institution prospective randomized trial, pediatric patients undergoing laparoscopic inguinal hernia repair were recruited from April 2023 to May 2024. Patients were randomized to general anesthesia with either an LMA or ETT. The primary endpoint was oxygen saturation in percent saturation (SpO2) measured at three standardized timepoints. Secondary endpoints were end tidal carbon dioxide (EtCO2) levels and peak airway pressure (PAP) measurements at the same three standardized timepoints as well as the occurrence of any episodes of laryngospasm or desaturation documented in each group.
</div><div><br></div><div><b>Results
</b></div><div>Fifty patients underwent laparoscopic inguinal hernia surgery with general anesthesia, twenty-five patients with LMA and twenty-five with ETT. There was no clinically significant difference in oxygenation between study groups. Additionally, there was no statistically significant difference between study arms in EtCO2 levels. Patients with ETT had higher peak airway pressures compared to patients with LMA at all three time points. There was one incident of desaturation in each study arm and no episodes of laryngospasm.
</div><div><br></div><div><b>Conclusions
</b></div><div>The use of LMA in short laparoscopic surgery is a safe and effective alternative to ETT in appropriate pediatric patients.</div>

Type: video · 0 min · posted 2025-09-23
Canonical: https://library.globalcastmd.com/watch/the-use-of-laryngeal-mask-airway-versus-endotracheal-intubation-in-pediatric-laparoscopic-inguinal-hernia-repair-a-randomized-controlled-trial-11030

## Chapters
- [0:01](https://library.globalcastmd.com/watch/the-use-of-laryngeal-mask-airway-versus-endotracheal-intubation-in-pediatric-laparoscopic-inguinal-hernia-repair-a-randomized-controlled-trial-11030?t=1) LMA vs ETT in Pediatric Laparoscopic Hernia Repair

## Statements
- "In laparoscopic surgery, the traditional airway approach is using endotracheal intubation" — Lizzie Lee (clinical) [0:11](https://library.globalcastmd.com/watch/the-use-of-laryngeal-mask-airway-versus-endotracheal-intubation-in-pediatric-laparoscopic-inguinal-hernia-repair-a-randomized-controlled-trial-11030?t=11)
- "A randomized trial studied 50 kids having laparoscopic hernia repair comparing LMA to endotracheal intubation" — Lizzie Lee (clinical) [0:21](https://library.globalcastmd.com/watch/the-use-of-laryngeal-mask-airway-versus-endotracheal-intubation-in-pediatric-laparoscopic-inguinal-hernia-repair-a-randomized-controlled-trial-11030?t=21)
- "There was no difference in oxygen saturation between LMA and endotracheal intubation groups" — Lizzie Lee (clinical) [0:26](https://library.globalcastmd.com/watch/the-use-of-laryngeal-mask-airway-versus-endotracheal-intubation-in-pediatric-laparoscopic-inguinal-hernia-repair-a-randomized-controlled-trial-11030?t=26)
- "There was no difference in tidal carbon dioxide levels between LMA and endotracheal intubation groups" — Lizzie Lee (clinical) [0:26](https://library.globalcastmd.com/watch/the-use-of-laryngeal-mask-airway-versus-endotracheal-intubation-in-pediatric-laparoscopic-inguinal-hernia-repair-a-randomized-controlled-trial-11030?t=26)
- "There was only one desaturation event in the LMA group" — Lizzie Lee (clinical) [0:33](https://library.globalcastmd.com/watch/the-use-of-laryngeal-mask-airway-versus-endotracheal-intubation-in-pediatric-laparoscopic-inguinal-hernia-repair-a-randomized-controlled-trial-11030?t=33)
- "There was only one desaturation event in the endotracheal intubation group" — Lizzie Lee (clinical) [0:33](https://library.globalcastmd.com/watch/the-use-of-laryngeal-mask-airway-versus-endotracheal-intubation-in-pediatric-laparoscopic-inguinal-hernia-repair-a-randomized-controlled-trial-11030?t=33)
- "For certain laparoscopic surgeries in children, an LMA might be just as safe as a traditional endotracheal tube" — Lizzie Lee (opinion) [0:37](https://library.globalcastmd.com/watch/the-use-of-laryngeal-mask-airway-versus-endotracheal-intubation-in-pediatric-laparoscopic-inguinal-hernia-repair-a-randomized-controlled-trial-11030?t=37)

## Transcript
When kids need laparoscopic surgery, do they really need a breathing tube, or could a less invasive airway work just as well? I'm Lizzie Lee from Cincinnati Children's, and this is an article you should know about. In laparoscopic surgery, the traditional airway approach is using endotracheal intubation. But are laryngeal mask airways or LMAs just as effective and safe? Researchers put it to the test in a randomized trial of 50 kids having laparoscopic hernia repair. The results, no different. In oxygen saturation or tidal carbon dioxide levels between the two groups. In terms of complications, there was only one desaturation in each group. The takeaway is that for certain laparoscopic surgeries in children, an LMA might be just as safe as a traditional endotracheal tube. Let us know what you think in the comments below and stay tuned for more articles that you should know about.

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Not medical advice · citation policy: https://library.globalcastmd.com/ai