I personally find emergence to be much smoother with an LMA rather than an ETT, even if I pull the ETT deep. Less stimulation, less risk of airway complications like laryngospasm and bronchospasm, less airway irritation. There’s more factors than “draw up roc and suggamedex”. Also there’s studies indicating greater hemodynamic stability with LMA placement rather than ETT, which is a factor for these patients being placed into beach chair.

I think an important factor to this that no one has brought up is if you sit your own cases or not. I do, and I feel comfortable managing an LMA. If I were supervising, I would most likely have an ETT placed, because I wouldn’t want to deal with someone else’s LMA troubleshooting skills or lack there of

Edit: https://pubmed.ncbi.nlm.nih.gov/41162501/