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Comparison of Rotational Technique versus Standard Technique of Laryngeal Mask Airway Insertion in Adults: A Prospective Randomised Controlled Study

Manisha Kanagarajan, Associate Professor, Dept of Anesthesia, ACS Medical College and Hospital, Velappanchavadi, Chennai, Tamil Nadu 600077, India. , Vanishree Chandran1 , Manisha Kanagarajan2

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Indian Journal of Anesthesia and Analgesia 4(4):p 1185-1191, October-December 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.44

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Abstract

Background and Aim: The Laryngeal mask airway (LMA) is widely used for elective short surgical procedures with both spontaneous and controlled ventilation. Brain’s standard technique of insertion is reliable but not always successful. The rotational technique has been proposed to overcome some difficulties posed by the standard technique. The aim of this study is to compare the rotational technique with the standard technique in terms of number of attempts, time taken for insertion, presence of leak, and incidence of complications like trauma, hypoxemia and laryngospasm. Methodology: 88 ASA I and II patients were randomly allocated into two groups, Group R and Group S. Anaesthesia was induced with Inj. Propofol and after jaw relaxation and absence of response to jaw thrust, LMA was inserted by the rotational technique in Group R and the standard technique in Group S. Successful placement was confirmed by chest expansion and a square wave capnographic tracing. The number of attempts, time taken for successful insertion and presence of leak were recorded. Trauma was assessed by blood stained LMA on removal. Results: The first attempt success rate was 93.2% in the standard group and 84.1% in the rotational group, the difference being statistically significant. The mean time taken for successful insertion in the standard and rotational group was not statistically significant. The rotational technique resulted in fewer leaks than the standard technique (No leak in 47% vs. 31.8%). The incidence of trauma was significantly less in the rotational group (11.4% Vs 18.2). Conclusion: The incidence of leak around the cuff and trauma were significantly less in the rotational technique.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.44

Keywords

Laryngeal Mask Airway Insertion; Rotational Technique; Brain’s Technique. 

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