title: The McIvor blade improves insertion of the LMA ProSeal™ in children.
abstract: BACKGROUND
  The McIvor blade, a tongue retractor with a thin curved blade, is used to improve the operating field during a tonsillectomy. We compared the success rate and incidence of complications between digital insertion and McIvor blade-guided insertion of the laryngeal mask airway (LMA™) ProSeal™ when performed by anesthesia residents in children.
  
  
  METHODS
  A total of 134 anesthetized non-paralyzed pediatric patients were included in the study. Patients were allocated randomly to one of two groups, i.e., Digital group (LMA ProSeal insertion using the digital insertion technique) or McIvor group (LMA ProSeal insertion using the Mclvor blade-guided technique). All patients were managed by anesthesia residents who were unskilled in using each technique. We assessed success rates of insertion at the first attempt, insertion time for an effective airway, and postoperative blood staining.
  
  
  RESULTS
  The success rate of insertion at the first attempt was higher in the McIvor group than in the Digital group (97% vs 78%, respectively; P = 0.003), and insertion time with a successful first attempt was shorter in the McIvor group than in the Digital group (20.5 [4.5] sec vs 22.8 [6.7] sec, respectively; P = 0.021). The overall insertion time for an effective airway was also shorter in the McIvor group than in the Digital group (20.9 [5.7] sec vs 26.0 [9.8] sec, respectively; P < 0.001). Blood staining was more frequent in the Digital group than in the McIvor group (23% vs 6%, respectively; P = 0.035).
  
  
  CONCLUSIONS
  When inserting the LMA ProSeal in children, anesthesia residents were more successful using the McIvor blade-guided insertion technique than using the digital insertion technique. (ClinicalTrials.gov number, NCT01191619).
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea.
authors.forename: Jinyoung
authors.initials: J
authors.lastname: Hwang
authors.forename: Sunghee
authors.initials: S
authors.lastname: Han
authors.forename: Jungwon
authors.initials: J
authors.lastname: Hwang
authors.forename: Ahyoung
authors.initials: A
authors.lastname: Oh
authors.forename: Seongjoo
authors.initials: S
authors.lastname: Park
authors.forename: Jinhee
authors.initials: J
authors.lastname: Kim
mesh_terms: D000776:Anesthesiology / Q000193:education; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods*; D017214:Laryngeal Masks; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D013997:Time Factors; D014068:Tonsillectomy / Q000379:methods*