title: Oral gastric tube-guided insertion of the ProSeal™ laryngeal mask is an easy and noninvasive method for less experienced users.
abstract: OBJECTIVE
  The ProSeal™ laryngeal mask airway (PLMA) can be more difficult to insert than the classic laryngeal mask, especially in patients who have a thin palate with a steep oropharyngeal curve. Here, an oral gastric (OG) tube-guided technique is considered as a method that makes it easier to successfully insert a PLMA.
  
  
  METHODS
  Sixty patients who were scheduled to undergo general anesthesia without neuromuscular blocking were randomly allocated into two groups: 30 patients with PLMA inserted by the standard digital technique, and 30 with the PLMA inserted by an OG tube-guided technique. Most PLMA insertions were performed by less experienced users. The success rate at the first attempt, the time taken to insert the PLMA, the difficulty of the procedure, and the incidence of oropharyngeal trauma and postoperative sore throat were compared between the two groups.
  
  
  RESULTS
  PLMA insertion was successfully achieved at the first attempt using the OG tube-guided technique in all 30 patients. The OG tube-guided insertion required fewer attempts (P = 0.04) and led to a less difficult insertion procedure (P = 0.02) than the standard digital insertion. Effective ventilation during anesthesia was achieved in all patients, with a lower mean cuff pressure in the OG tube-guided technique group (P = 0.02). The frequency of blood sticking to the PLMA tube (P < 0.001) and the incidence of postoperative sore throat (P = 0.003) were lower in the OG tube-guided group than the standard digital technique group.
  
  
  CONCLUSIONS
  OG tube-guided PLMA insertion is easier for less experienced users, trainees, and experts as well as less invasive for patients than the standard digital insertion.
authors.affiliation: Department of Anesthesiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari, Osaka, 537-8511, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Nagata
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kishi
authors.forename: Hironobu
authors.initials: H
authors.lastname: Tanigami
authors.forename: Yuki
authors.initials: Y
authors.lastname: Hiuge
authors.forename: Shunji
authors.initials: S
authors.lastname: Sonoda
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Ohashi
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Kagawa
authors.forename: Azusa
authors.initials: A
authors.lastname: Ushioda
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D001940:Breast / Q000601:surgery; D002983:Clinical Competence; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D017214:Laryngeal Masks / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010173:Palpation; D010612:Pharyngitis / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology; D016896:Treatment Outcome; D013520:Urologic Surgical Procedures / Q000379:methods