Accuration Insertion Lma with Video Laryngoscope Compare with Classic Technique

Abstract

Background: Laryngeal Mask Airways (LMA) is often performed for airway management. Many insertion techniques of supraglottic airway devices have been described in an attempt to obtain an accurately-positioned and a well-functioning airway. The classic insertion technique, as advised by the manufacturers is frequently used, but this insertion is usually blind without knowing whether the mask sits perfectly, and is often left in position as long as adequate ventilation of the lungs is achieved. Methods: In this double-blind randomized controlled trial, the study subjects (total 106 patients) were divided into two groups, using either videolaryngoscopy-guided or classic blind insertion techniques. The study compared the accuracy of the LMA position based on the Fiberoptic Laryngeal Score (FLS), the clinical score, the number of insertion attempts of the LMA and complications such as a sore throat and blood on the LMA cuff. Result: Correct insertion of the LMA by videolaryngoscope was significantly higher than the use of the classic blind insertion technique based on FLS assessment (79.2% vs 17%, p <0.05) and clinical score (100% vs 88.7%, p < 0.05). The first attempt success insertion rate of LMAs was significantly higher superior in the group using videolaryngoscopy (100% vs 88.7%, p < 0.05). The incidence of sore throat was not statistically significantly different, while for the incidence of blood present on LMA cuffs obtained statistically significant with p value 0.028. Conclusion: Videolaryngoscop is a useful tool for insertion and guiding the LMA in a correct position. The camera on the tip of the video laryngoscope blade provides a wider angle view than that obtained with classic laryngoscopes, and thus we can place LMA in front of the vocal cords more easily.