title: Insertion of the ProSeal laryngeal mask airway is more successful with the 90 degrees rotation technique.
abstract: OBJECTIVE
  The 90 degrees rotation technique for inserting the ProSeal laryngeal mask airway (PLMA) in anesthetized paralyzed patients was compared with the index finger insertion technique.
  
  
  METHODS
  One hundred twenty Asian adult patients were randomly allocated to either a standard technique group or a rotation technique group. A PLMA size 4 was used for women and size 5 was used for men. In the standard technique group (n = 60), the PLMA was inserted using the index finger. In the rotation technique group (n = 60), the entire cuff of the PLMA was placed in the patient's mouth in a midline approach without finger insertion, rotated 90 degrees counter clockwise around the patient's tongue, advanced and then rotated back until resistance was felt. The primary outcome was success at first insertion. Secondary outcome measures were insertion time and complications.
  
  
  RESULTS
  The success rate at first insertion was greater for the rotation technique group than for the standard technique group (100% vs 83%, respectively; P = 0.003), and less time was required (11 +/- 3 sec vs 19 +/- 16 sec, respectively; P = 0.03). The incidence of postoperative sore throat was lower for the rotation technique group than for the standard technique group (12% vs 33%, respectively; P = 0.009), and blood staining on the PLMA was less (8% vs 40%, respectively; P < 0.001).
  
  
  CONCLUSIONS
  The 90 degrees rotation technique for inserting the PLMA is more successful than the standard index finger insertion technique. It is associated with fewer side effects, such as blood on the PLMA and sore throat, which suggests it causes less pharyngeal trauma.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Kyonggi-do, 463-707, South Korea.
authors.forename: Young-Tae
authors.initials: YT
authors.lastname: Jeon
authors.forename: Hyo Seok
authors.initials: HS
authors.lastname: Na
authors.forename: Sang-Hyun
authors.initials: SH
authors.lastname: Park
authors.forename: Ah-Young
authors.initials: AY
authors.lastname: Oh
authors.forename: Hee-Pyoung
authors.initials: HP
authors.lastname: Park
authors.forename: Mi-Ja
authors.initials: MJ
authors.lastname: Yun
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Kim
authors.forename: Jung-Won
authors.initials: JW
authors.lastname: Hwang
mesh_terms: D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D017214:Laryngeal Masks / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010612:Pharyngitis / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies