Comparison of two insertion techniques of ProSeal laryngeal mask airway: standard versus 90-degree rotation.
BACKGROUND
This study compared two insertion techniques of ProSeal laryngeal mask airway.


METHODS
A total of 160 female patients (American Society of Anesthesiologists physical status I or II; age 18-80 yrs) undergoing gynecologic surgery were randomly allocated to the standard or rotational technique groups. In the standard technique group (n = 80), ProSeal laryngeal mask airway insertion was performed by a single experienced user using digital manipulation. In the rotational technique group (n = 80), the ProSeal laryngeal mask airway was rotated counter clockwise through 90 degrees in the mouth and advanced until the resistance of the hypopharynx was felt, and then straightened out in the hypopharynx (n = 80). The ease of insertion was assessed by the success rate at the first attempt. Heart rate and mean blood pressure were recorded 1 min before and 1 min after insertion. Postoperative complications were noted.


RESULTS
The success rate of insertion at the first attempt was higher for the rotational technique (100% vs. 85%, P < 0.001). The overall success rate, i.e., successful insertion within three attempts, was 94% for the standard technique versus 100% for the rotational technique. There was no significant change in heart rate, but mean blood pressure increased significantly with the standard technique (P = 0.001). The incidence of blood staining (9% vs. 36%, P < 0.001) and sore throat (8% vs. 25%, P = 0.005) was lower with the rotational technique.


CONCLUSIONS
The rotational technique is more successful than the standard technique and is associated with less pharyngeal mucosal trauma, as evidenced by a lower incidence of sore throat and mucosal bleeding.
Hwang
Jung-won
JW
Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea.
Park
Hee-Pyoung
HP
Lim
Young-Jin
YJ
Do
Sang-Hwan
SH
Lee
Sang-Chul
SC
Jeon
Young-Tae
YT
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D005260:Female; D006339:Heart Rate; D006801:Humans; D017214:Laryngeal Masks; D008875:Middle Aged; D010612:Pharyngitis / Q000209:etiology*; D011446:Prospective Studies; D055815:Young Adult