title: A comparison of classic laryngeal mask airway insertion between lightwand- and standard index finger-guided techniques.
abstract: OBJECTIVE
  To compare the efficacy of lightwand-guided classic laryngeal mask airway (cLMA) real-time insertion technique with the standard recommended index finger-guided insertion technique.
  
  
  METHODS
  Prospective, randomized controlled study.
  
  
  METHODS
  University-affiliated hospital.
  
  
  METHODS
  Three hundred patients undergoing minor gynecological or orthopedic surgeries under general anesthesia using the cLMA as an airway management tool.
  
  
  METHODS
  Patients were randomly divided into either lightwand-guided group or standard group.
  
  
  METHODS
  Fiberoptic bronchoscopy was used to determine the cLMA position after a cLMA was inserted. The first attempt and total success rates of the cLMA insertion, insertion time, distances from the end of cLMA pilot tube to the upper central incisors, views of fiberoptic bronchoscopy, blood staining, tidal volume, airway pressure, end-tidal CO2, SpO2, noninvasive hemodynamic parameters, and others were compared.
  
  
  RESULTS
  The cLMA was all successfully inserted within 3 attempts except for 2 patients in the standard group. The success rates of lightwand-guided insertion technique at first attempt were significantly higher than standard insertion technique; the ideal view rates assessed by fiberoptic bronchoscopy in lightwand-guided group patients were also significantly higher than in standard group patients, but the insertion time of first successful attempt was similar; the blood staining rates on the cLMA in lightwand-guided group patients were significantly less than in standard group patients. The depths of cLMA insertion in standard group patients were significantly deeper than those in lightwand-guided group patients. There was no significant difference in end-tidal CO2, SpO2, airway pressure, and hemodynamic variables.
  
  
  CONCLUSIONS
  Lightwand-guided cLMA insertion technique can provide a more objective indicator for correct cLMA positioning, higher first attempt success rates, better glottic views, and less damage to oropharyngeal or esophagus tissues than standard index finger-guided cLMA insertion technique.
authors.affiliation: Department of Anesthesiology, Fudan University Shanghai Cancer Center, 270 Dongan Road, Shanghai 200032, China.
authors.forename: Wenqing
authors.initials: W
authors.lastname: Lu
authors.affiliation: Department of Anesthesiology, Shanghai Children's Medical Center Affiliated to School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Pudong, Shanghai 200127, China.
authors.forename: Jijian
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Department of Anesthesiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Road, Shanghai 200080, China.
authors.forename: Lingqi
authors.initials: L
authors.lastname: Gao
authors.affiliation: Department of Anesthesiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Road, Shanghai 200080, China. Electronic address: yingtianwang201@sina.com.
authors.forename: Yingtian
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D058109:Airway Management / Q000295:instrumentation / Q000379:methods*; D000768:Anesthesia, General; D001784:Blood Gas Analysis; D001999:Bronchoscopy; D005260:Female; D005336:Fiber Optic Technology; D013509:Gynecologic Surgical Procedures; D006439:Hemodynamics; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D010173:Palpation / Q000379:methods*; D011446:Prospective Studies; D055815:Young Adult
keywords: Airway management; Insertion technique; Laryngeal mask airway; Lightwand