Effect of Airway Devices on Emergence Delirium in Pediatric Strabismus Surgery

BACKGROUND Pediatric anesthesia emergence delirium (PAED), with symptoms including agitation, hyperactivity, and confusion, is common in children undergoing general anesthesia. This study aimed to compare the effect of an endotracheal tube (ETT) and a laryngeal mask airway (LMA) on emergence delirium (ED) in 73 children undergoing strabismus surgery. MATERIAL AND METHODS Seventy-three children aged 3 to 9 years were enrolled and randomly assigned to 2 groups: 36 patients in the LMA group (group L) and 37 patients in the ETT group (group E). The primary endpoint was the existence of ED, defined as a PAED scale score exceeding 10. Secondary endpoints were PAED scale scores, the Face, Legs, Activity, Cry, Consolability (FLACC) scale scores, measured every 5 min, intubation and extubation times, complications, airway responses following intubation, and post-anesthesia care unit (PACU) stay duration. RESULTS Seventy-three patients were included in the final analysis. Intubation time and PACU stay were significantly shorter in group L than in group E (P=0.02). Group E demonstrated higher PAED scale scores at 0, 5, 10, 20, and 25 min after surgery (P=0.062, 0.029, 0.019, 0.007, and 0.028, respectively). FLACC scores were also higher in group E, at 20, 25, and 30 min after surgery (P=0.016, 0.029, and 0.026, respectively). The presence of ED was lower in group L than in group E, at 5, 10, and 15 min (P=0.024, 0.008, and 0.025, respectively). CONCLUSIONS LMA is better than ETT in pediatric strabismus surgery, as it reduces postoperative pain and PACU stay.