title: Optimal conditions for Laryngeal Mask Airway insertion in children can be determined by the trapezius squeezing test.
abstract: OBJECTIVE
  To evaluate the trapezius squeezing test as a criterion of adequate anesthetic depth for Laryngeal Mask Airway (LMA) insertion in children without neuromuscular blocking agents.
  
  
  METHODS
  Prospective, randomized clinical trial.
  
  
  METHODS
  Operating room of a university hospital.
  
  
  METHODS
  45 ASA physical status I and II children, aged one to 6 years, undergoing minor surgical procedures.
  
  
  METHODS
  An LMA was inserted in each child after the trapezius squeezing test turned to be negative.
  
  
  METHODS
  Presence of coughing, gagging, gross purposeful movements, breath holding, laryngospasm, or desaturation during or within one minute of LMA insertion were recorded. Elapsed time of LMA insertion, end-tidal sevoflurane concentration, blood pressure, and heart rate values were also noted.
  
  
  RESULTS
  LMA insertion was successful in 41 patients. Elapsed time to complete insertion was 5.7 +/- 1.9 minutes, and end-tidal sevoflurane concentration was 3.6 +/- 1.1 vol%. No marked hemodynamic changes occurred in any child.
  
  
  CONCLUSIONS
  The trapezius squeezing test is a reliable clinical indicator to assess adequate anesthetic depth for LMA insertion in children without neuromuscular blocking agents.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, CPO Box 8044, Seoul 120-752, Republic of Korea.
authors.forename: Chul Ho
authors.initials: CH
authors.lastname: Chang
authors.forename: Yon Hee
authors.initials: YH
authors.lastname: Shim
authors.forename: Yang-Sik
authors.initials: YS
authors.lastname: Shin
authors.forename: Ki-Young
authors.initials: KY
authors.lastname: Lee
mesh_terms: D000758:Anesthesia; D018685:Anesthetics, Inhalation; D001415:Back; D001794:Blood Pressure / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007223:Infant; D017214:Laryngeal Masks; D008297:Male; D008738:Methyl Ethers; D018482:Muscle, Skeletal / Q000502:physiology*; D009333:Neck; D011312:Pressure; D011446:Prospective Studies; D000077149:Sevoflurane; D013990:Tidal Volume / Q000502:physiology; D013997:Time Factors
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane