Abstract:

Objective To investigate the feasibility and safety of using diaphragmatic ultrasound to guide timing of laryngeal mask extraction during anaesthesia for laparoscopic inguinal hernia surgery in children. Methods A total of 140 children undergoing laparoscopic inguinal hernia repair surgery were selected， and the children were randomly divided into two groups： the group with laryngeal mask extraction guided by diaphragmatic ultrasound （Group D） and the group with laryngeal mask extraction guided by awake （group A）. The two groups were instructed on the timing of laryngeal mask extraction according to different ways， and the incidence of adverse events， such as difficulty in pulling out， cough， laryngospasm， bronchospasm， and pharyngeal pain， were compared between the two groups during and after the extraction， the analysis compared the incidence and management of peripheral oxygen desaturation between the two groups. Results The rates of difficulty in pullout and laryngospasm in group D were both lower than those in group A， and the number of cases of adverse events in group D was lower than that in group A， the difference was statistically significant. The incidence of oxygen desaturation after removal of the laryngeal mask was lower in group D than in group A， and the difference was statistically significant.The time from the end of surgery to removal of the laryngeal mask and the steward awakening score up to 4 points in group D were shorter than those in group A， and the differences were statistically significant. Conclusion During awakening from anaesthesia for laparoscopic inguinal hernia surgery in children， monitoring the rate of change in diaphragmatic thickness with ultrasound can lead to better guidance in the extraction of laryngeal mask with a lower incidence of adverse effects and greater safety.

Key words: inguinal hernia, diaphragm, ultrasonic, children, laryngeal mask