title: Comparison of a new visual stylet (Discopo)-guided laryngeal mask airway placement vs conventional blind technique: a prospective randomized study.
abstract: OBJECTIVE
  To compare the ease of laryngeal mask airway (LMA) insertion and fiberoptic view of LMA after placement using the Discopo visual stylet-guided insertion and conventional blind technique.
  
  
  METHODS
  Prospective, randomized controlled study.
  
  
  METHODS
  Operating room in a university hospital.
  
  
  METHODS
  One hundred adult patients scheduled for elective surgery under LMA general anesthesia were enrolled.
  
  
  METHODS
  Patients were randomly allocated to 2 groups: GLMA group using a visual stylet-guided technique (n=50) and BLMA group using standard blind technique (n=50). Correct placement of the LMA was confirmed using clinical test along with fiberoptic assessment.
  
  
  METHODS
  Unblinded data were collected about the insertion time, the first attempt success rate, the LMA position adjustment rate, fiberoptic view of LMA anatomical position, hemodynamic responses, and the adverse insertion responses (bucking, breathholding, and laryngospasm). Blinded data were recorded about postoperative airway morbidity (visible blood staining on LMA at removal, sore throat, and hoarseness).
  
  
  RESULTS
  Insertion was more frequently successful at the first attempt in GLMA than that in BLMA group (100% vs 92%; P=.041). The time taken for establishing effective airway was shorter in GLMA than that in BLMA (54.8 vs 62.9 seconds; P=.001). The patients in BLMA group required more readjustment and reinsertion than those in GLMA group (38% vs 0%; P=.000). The fiberoptic view was significantly better in GLMA group (P<.001). No difference between the 2 groups existed regarding hemodynamic stress responses, incidences of adverse insertion responses, and postoperative airway morbidity.
  
  
  CONCLUSIONS
  By direct visualizing the whole process of LMA insertion, the Discopo visual stylet increases the success rate and accuracy rate of LMA placement without increasing hemodynamic stress response or incidences of adverse events.
authors.affiliation: Department of Anesthesiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China.
authors.forename: Linlin
authors.initials: L
authors.lastname: Zhao
authors.affiliation: Department of Anesthesiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China.
authors.forename: Junfeng
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China.
authors.forename: Quanhong
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Department of Anesthesiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200233, China. Electronic address: jiangw@sjtu.edu.cn.
authors.forename: Wei
authors.initials: W
authors.lastname: Jiang
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000379:methods*; D017558:Elective Surgical Procedures; D005260:Female; D005336:Fiber Optic Technology; D006439:Hemodynamics; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D017214:Laryngeal Masks / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000293:injuries; D011446:Prospective Studies; D011897:Random Allocation; D013997:Time Factors
keywords: Insertion; Laryngeal mask airway; Visual stylet