ALTERNATE METHOD FOR DETERMINING THE SIZE OF CLASSIC LARYNGEAL MASK AIRWAY (CLMA) IN CHILDREN. A PROSPECTIVE OBSERVATIONAL STUDY

Introduction: The classic laryngeal mask airway (cLMA) is a widely used supraglottic airway device in pediatric anesthesia. Accurate size selection is crucial to ensure effective ventilation and reduce complications. Traditionally, cLMA size is determined using weight-based guidelines. However, in emergency or low-resource settings, estimating weight may be challenging, prompting the need for alternative sizing methods. Objective: To determine an agreement between weight-based and Auricle-size methods of selecting the correct size of cLMA in children undergoing genitourinary surgery. Materials and Method: The study was a prospective observational study of 100 children ranging in age from 1 to 15 years at SIUT Karachi, Department of Anesthesiology, between June and November 2024. The size of cLMA based on auricle size and based on weight was noted. The Kappa statistics were used to measure whether the methods agreed or not. Results: There was a moderately high agreement (Kappa = 0.616, p = 0.0005). Subgroup analyses increased the consistency of findings in the age, weight, and gender. Conclusion: Auricle-size-based estimation is a reliable and practical alternative to weight-based cLMA size selection in pediatric patients.