Airway management using LMA-evaluation of three insertional techniques-a prospective randomised study.

Journal of Anaesthesiology, Clinical Pharmacology
T Shyam, Venkatesh Selvaraj

Abstract

Laryngeal Mask Airway [LMA] insertion has become as a basic procedural skill needed for all health care providers. Search for the most successful insertion technique continues. We evaluated the success rate of the three LMA insertion techniques- standard, 90 degree rotational and 180 degree rotational technique. A total of 180 patients of ASA I-II aged 18-65 years undergoing open superficial surgical procedures with (LMA® Unique™ Airway, Teleflex®, Teleflex Medical Europe Ltd, Ireland) as an airway management device and with neuromuscular blocking agents, were randomly allocated to three groups, in this prospective randomized study. In the standard technique group (n = 60), the LMA was inserted by standard digital intraoral method. In the 90 degree rotational technique group (n = 60), the LMA was rotated counter-clockwise through 90 degree in the mouth and advanced until the resistance of the hypopharynx was felt, and then straightened out in the hypopharynx. In 180 degree rotational technique, LMA was inserted back-to-front, like a Guedel airway. The parameters studied were: the LMA placement success at first attempt, insertion time, need for more than one attempt at insertion, need for external airway manipulations, postopera...Continue Reading

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