Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 0 0 2026 10 16 1651 1651 Seyed Alireza Mahdavi Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Ahmad Eghbali Zarch Department of Anesthesiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Nastaran Sadat Mahdavi Department of Anesthesiology, Mofid Children’s Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tara Darabi Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2026 06 02 2026 07 01 Background: Pediatric patients are particularly vulnerable to airway stimulation, increasing the risk of perioperative respiratory adverse events such as laryngospasm and cough during emergence. Although the laryngeal mask airway (LMA) is less invasive than endotracheal intubation, it may still provoke airway irritation. This randomized clinical trial compared lidocaine gel with simple lubricant applied to the LMA surface in reducing airway-related complications in children. Methods: Sixty children undergoing elective surgery at Mofid Children’s Hospital, Tehran, were randomly assigned to two groups (n=30 each). In the intervention group, lidocaine gel was used as the LMA lubricant; in the control group, a simple lubricant was applied. Demographic variables, underlying disease, laryngospasm, recovery-room cough, and cough 12 hours postoperatively were recorded and analyzed. Results: Demographic characteristics did not differ significantly between groups (P>0.05). Laryngospasm and recovery-room cough occurred in none of the patients in the lidocaine group and in one patient (3.33%) in the control group, without statistical significance (P>0.05). No patient in either group experienced a cough 12 hours after surgery. Conclusion: This study suggests that lidocaine gel, when used as an LMA lubricant in pediatric patients, may offer a potential advantage in attenuating airway-related complications during LMA removal, compared to simple lubricants. Considering its favorable safety profile and the observed trend towards improved airway stability, lidocaine gel warrants consideration as a beneficial adjunct for optimizing airway management in this population. https://aacc.tums.ac.ir/index.php/aacc/article/view/1651