title: ProSeal laryngeal mask airway™ insertion in the prone position: Optimal utilization of operation theatre personnel and time?
abstract: BACKGROUND
  Positioning an anesthetized patient prone is challenging with regard to manpower requirement, time to surgical readiness and airway management. The ProSeal laryngeal mask airway™ (PLMA) is emerging as a suitable alternative, both as a primary and a rescue airway device to the tracheal tube (TT) for patients undergoing surgery in the prone position.
  
  
  METHODS
  In this prospective randomized study, 70 patients scheduled to undergo pilonidal sinus excision in prone position were allocated to two groups of 35 patients each, depending on the position of the patient at induction and device placement: Group S (device placed while supine) and Group P (device placed while prone). We compared the manpower requirement, time to surgical readiness, efficacy and safety of the PLMA for airway management in the two groups.
  
  
  RESULTS
  The number of personnel [5 (4-6) vs. 3 (3-3); P < 0.001] required for positioning the patient and surgical readiness time (22.1 ± 3 vs. 5.9 ± 0.9 min; P < 0.001) was higher in group S. There was no difference between the two groups with regard to efficacy and safety of the PLMA. Incidence of blood on the PLMA cuff and sore throat was comparable in the two groups (P = 1.000).
  
  
  CONCLUSIONS
  We conclude that induction and placing the PLMA in the prone position by experienced users require fewer personnel and reduces surgical readiness time.
authors.affiliation: Department of Anaesthesiology, Pain and Perioperative Medicine, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Bimla
authors.initials: B
authors.lastname: Sharma
authors.affiliation: Department of Anaesthesiology, Pain and Perioperative Medicine, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Jayashree
authors.initials: J
authors.lastname: Sood
authors.affiliation: Department of Anaesthesiology, Pain and Perioperative Medicine, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Raminder
authors.initials: R
authors.lastname: Sehgal
authors.affiliation: Department of Anaesthesiology, Pain and Perioperative Medicine, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Chand
authors.initials: C
authors.lastname: Sahai
authors.affiliation: Department of Anaesthesiology, Pain and Perioperative Medicine, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Anjali
authors.initials: A
authors.lastname: Gera
keywords: Equipment; ProSeal laryngeal mask airway; prone position; technique