Removal of Laryngeal Mask Airway: Awake or Deep Anesthesia?

Background: the aim of this study was to study the influence of depth of anesthesia (awake or deep anesthesia) and choiceof anesthetic drug (halothane or propofol) on the incidence and severity of airway hyperreactivity associated with laryngealmask airway (lma) removal.methods: a prospective, randomized, double blind study was done in 156 asa physical status i and ii patients, aged 18-65years, who had under gone short time elective surgery (<1 hour). patients were randomly assigned in one of the foursubgroups: hal-aw (anesthesia maintenance with halothane and lma removal in awaked state), hal-deep (anesthesia maintenancewith halothane and lma removal in deep anesthesia), pro-aw (anesthesia maintenance with propofol and lmaremoval in awaked state), and pro-deep (anesthesia maintenance with propofol and lma removal in deep anesthesia). theincidence of cough and straining, bronchospasm, laryngospasm, breathholding, vomiting, oxygen desaturation, and severityof airway hyperreactivity (mild, moderate, severe) with lma removal were evaluated.results: there were no significant differences in bronchospasm, larynchospasm, oxygen desaturation among foursubgroups. significant differences were in cough and straining, breath holding, vomiting, and finally severity of airwayhyperreactivity among four subgroups. depth of anesthesia didn’t have any effect on incidence and severity of airway hyperreactivitybut in those with propofol, they were lower than those with halothane.conclusion: in short time surgery and with use of lma, anesthesia with propofol is associated with lower incidence andseverity of airway hyperreactivity than halothane.