title: Comparison of three insertion techniques of ProSeal laryngeal mask airway: A randomized clinical trial.
abstract: OBJECTIVE
  We aimed to compare three techniques for insertion of ProSeal laryngeal mask airway (PLMA).
  
  
  METHODS
  Two hundred ten patients (American Society of Anaethesiologists I-II, aged 18-60 years) undergoing general anesthesia using the PLMA as an airway management device were randomly allocated to digital (D), rotational (R), or pharyngoscopic (P) techniques. In the D group (n= 70), the PLMA insertion was performed by using digital manipulation. In the R group (n= 70), the PLMA was inserted into the mouth, rotated anticlockwise through 90° and advanced into the hypopharynx. In thePgroup (n= 70), the PLMA was inserted after gentle pharyngoscopy using laryngoscope. Success rate at the first attempt, insertion time, airway manipulations required, and postoperative complications were noted.
  
  
  RESULTS
  Insertion at first attempt was more successful withPtechnique than the R and D groups (100% vs. 98.5% vs. 81.4% respectively,P< 0.01). Insertion time was shortest for thePgroup which was statistically significant compared to the group D (P< 0.001), but comparable with the R group. None of the patients required manipulation in thePgroup compared to the group R (P= 0.04) and D (P< 0.001). Blood staining (groupP= 2.8% vs. group R = 2.8% vs. group D = 22%,P< 0.0001) and sore throat (groupP= 0% vs. group R = 6.9% vs. group D = 16.7%, both:P< 0.005) were lower with the pharyngoscopic technique.
  
  
  CONCLUSIONS
  We conclude that the pharyngoscopic technique for PLMA insertion is more successful with lower incidence of complications (mucosal bleeding and sore throat).
authors.affiliation: Department of Anaesthesiology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Kadirehally Bheemanna
authors.initials: KB
authors.lastname: Nalini
authors.affiliation: Department of Anaesthesiology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Shivanna
authors.initials: S
authors.lastname: Shivakumar
authors.affiliation: Department of Anaesthesiology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Shivashankar
authors.initials: S
authors.lastname: Archana
authors.affiliation: Department of Anaesthesiology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Doddagavanahalli Channaiah
authors.initials: DC
authors.lastname: Sandhya Rani
authors.affiliation: Department of Anaesthesiology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Chadalavada Venkata Rama
authors.initials: CV
authors.lastname: Mohan
keywords: Insertion technique; ProSeal laryngeal mask airway; success rate