title: The rotational technique with a partially inflated laryngeal mask airway improves the ease of insertion in children.
abstract: BACKGROUND
  This study compared the ease of insertion of the laryngeal mask airway (LMA) with a partially inflated cuff using the standard 'nonrotational' technique versus the rotational technique.
  
  
  METHODS
  One hundred and forty-five children undergoing anaesthesia using the LMA were randomly assigned to either method. The cuff was partially inflated in both groups. The ease of insertion was assessed by the time taken to complete the LMA insertion, the number of attempts before successful placement and the occurrence of complications.
  
  
  RESULTS
  The success rate of insertion at the first attempt was higher in the rotational technique group (99% versus 79%, P < 0.05). All patients in the rotational group had the mask inserted within two attempts. On the other hand, three patients had the mask inserted on the first attempt with the rotational technique after three unsuccessful attempts by an anaesthesiologist with the standard 'nonrotational' technique. Insertion technique made no difference on insertion time.
  
  
  CONCLUSIONS
  The rotational technique was associated with a higher success rate for insertion and a lower incidence of complications in children. Using the rotational technique with a partially inflated cuff could be the first-choice approach in paediatric patients.
authors.affiliation: Department of Anaesthesiology, Ibaraki Children's Hospital, Mito, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Nakayama
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Osaka
authors.forename: Masao
authors.initials: M
authors.lastname: Yamashita
mesh_terms: D000758:Anesthesia / Q000379:methods*; D018685:Anesthetics, Inhalation / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007431:Intraoperative Complications; D017214:Laryngeal Masks; D008738:Methyl Ethers / Q000627:therapeutic use; D009609:Nitrous Oxide / Q000627:therapeutic use; D011446:Prospective Studies; D012399:Rotation; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D009609:Nitrous Oxide