Comparison of Two Insertion Techniques of ProSeal™ Laryngeal Mask Airway

Hwang, Jung‐Won; Park, Hee Pyoung; Lim, Young-Jin; Hwan, Sang; Lee, Sangchul; Jeon, Young-Tae

doi:10.1097/aln.0b013e31819b5d40

Cited by 43 publications

(71 citation statements)

References 14 publications

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“…This success rate is consistent with previous reports, in which the primary success rate for i-gel insertion with the standard technique was 78-93% [8,10,17]. Our previous reports comparing two insertion techniques for the ProSeal LMA showed that the success rate at the first attempt was significantly higher in the rotation group than in the standard technique group [13][14][15], similar to the present study using the i-gel. Our findings suggest that the standard digital technique to insert supraglottic airway devices such as the i-gel or ProSeal LMA should be replaced with the rotational technique to increase the first-attempt insertion success rate.…”

Section: Discussionsupporting

confidence: 93%

“…A recent case report showed that the reverse technique for i-gel insertion, with the device inserted into the mouth upside-down, may be useful to improve the insertion success rate when the first attempt by the standard technique fails [12]. Our previous studies demonstrated that the rotational technique provides a higher success rate at the first attempt with less pharyngeal mucosal trauma than the standard technique for insertion of the ProSeal TM laryngeal mask airway (LMA) [13][14][15]. To our knowledge, there have been no previous reports regarding the efficacy of the rotational technique for i-gel insertion.…”

Section: Introductionmentioning

confidence: 99%

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A prospective randomised comparison of two insertion methods for i-gel^™placement in anaesthetised paralysed patients: standard vs rotational technique

et al. 2014

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SummaryIn this prospective randomised study, we compared two techniques for i-gel TM insertion. One hundred and eighty-one anaesthetised, paralysed adult patients were randomly allocated into one of two groups. In the standard group (n = 91), the i-gel was inserted using the standard technique. In the rotation group (n = 90), the i-gel was rotated 90°a nticlockwise in the mouth and re-rotated in the hypopharynx to the original alignment. The success rate, insertion time, air leak pressure and complications were assessed. The success rate for insertion at the first attempt was lower for the standard technique, 78 (86%) vs 87 (97%; p = 0.016). The mean (SD) insertion time was longer (26.9 (14.5) s vs 22.4 (10.2) s; p = 0.016) and air leak pressure was lower (22.5 (10.4) cmH 2 O vs 27.1 (9.4) cmH 2 O; p = 0.002) in the standard group. The incidence of bloodstaining was higher with the standard technique (8 (9%) vs 1 (1%); p = 0.034). This study suggests that the rotational technique is superior to the standard technique for i-gel insertion.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

A prospective randomised comparison of two insertion methods for i-gel^™placement in anaesthetised paralysed patients: standard vs rotational technique

et al. 2014

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“…In a recent study, the rotation technique was associated with a higher success rate and less postoperative sore throat than the standard technique. 7 However, the study was limited to small-sized (size 3) PLMAs and women patients breathing spontaneously undergoing brief surgery. Larger sizes (size 4 or 5 for women and size 5 for men) are recommended to ensure a good seal and to allow positive pressure ventilation.…”

Section: Résumémentioning

confidence: 99%

Insertion of the ProSeal™ laryngeal mask airway is more successful with the 90° rotation technique

Jeon

Park

et al. 2010

Can J Anesth/J Can Anesth

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Purpose The 90°rotation technique for inserting the ProSeal TM laryngeal mask airway (PLMA) in anesthetized paralyzed patients was compared with the index finger insertion technique. Methods One hundred twenty Asian adult patients were randomly allocated to either a standard technique group or a rotation technique group. A PLMA size 4 was used for women and size 5 was used for men. In the standard technique group (n = 60), the PLMA was inserted using the index finger. In the rotation technique group (n = 60), the entire cuff of the PLMA was placed in the patient's mouth in a midline approach without finger insertion, rotated 90°c ounter clockwise around the patient's tongue, advanced and then rotated back until resistance was felt. The primary outcome was success at first insertion. Secondary outcome measures were insertion time and complications. Results The success rate at first insertion was greater for the rotation technique group than for the standard technique group (100% vs 83%, respectively; P = 0.003), and less time was required (11 ± 3 sec vs 19 ± 16 sec, respectively; P = 0.03). The incidence of postoperative sore throat was lower for the rotation technique group than for the standard technique group (12% vs 33%, respectively; P = 0.009), and blood staining on the PLMA was less (8% vs 40%, respectively; P \ 0.001).Conclusion The 90°rotation technique for inserting the PLMA is more successful than the standard index finger insertion technique. It is associated with fewer side effects, such as blood on the PLMA and sore throat, which suggests it causes less pharyngeal trauma. (Clinical trial registration number: NCT00966186). RésuméObjectif La technique de rotation a`90°pour inse´rer le masque larynge´ProSeal TM (PLMA) chez des patients anesthe´sie´s curarise´s a éte´compare´e à la technique d'insertion avec l'index. Méthode Cent vingt patients adultes asiatiques ont e´teá le´atoirement re´partis en deux groupes, soit un groupe avec technique d'insertion standard et l'autre avec technique de rotation. Un masque PLMA de taille 4 a e´te´utilise´chez les femmes et un masque de taille 5 chez les hommes. Dans le groupe avec technique d'insertion standard (n = 60), le PLMA a e´te´inse´re´a`l'aide de l'index. Dans le groupe avec technique de rotation (n = 60), la manchette du PLMA a e´te´place´e en entier dans la bouche du patient a`l'aide d'une approche par ligne me´diane sans insertion de doigt, tourne´e de 90°dans le sens inverse des aiguilles d'une montre autour de la langue du patient, avance´e puis retourne´e jusqu'a`ressentir une re´sistance. Le crite`re d'e´valuation principal e´tait la re´ussite a`la premie`re insertion. Les crite`res d'e´valuation secondaires comprenaient le temps d'insertion et les complications. Résultats Le taux de re´ussite a`la premie`re insertion e´tait plus e´leve´dans le groupe avec technique de rotation que dans le groupe avec technique d'insertion standard (100 %

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“…A 90° rotation technique has been described, and it is more successful than the standard technique and is associated with less airway morbidity (12). It does not involve the use of additional introducer aids.…”

mentioning

confidence: 99%

A Prospective Randomised Clinical Trial for the Comparison of Two Techniques for the Insertion of Proseal Laryngeal Mask Airway in Adults-Index Finger Insertion Technique versus 90° Rotation Technique

Dhulkhed¹,

Khyadi²,

Jamale³

et al. 2017

Turk J Anaesth Reanim

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Objective: The 90° rotation technique for inserting the Proseal laryngeal mask airway (PLMA) is reported to be better than the standard index finger insertion technique to improve the insertion success rate. The objective of this study was to evaluate and compare the ease of insertion through the 90° rotation and standard insertion techniques in terms of number of attempts, duration of insertion and occurrence of complications. Methods:One hundred and twenty adult patients were allocated to either a standard technique group or rotation technique group with 60 patients in each. In the rotation technique group, the entire cuff of the PLMA was placed in the patient's mouth in a midline approach without finger insertion, rotated 90° counter-clockwise around the patient's tongue, advanced and rotated back until resistance was felt. Results:The success rate of the rotation technique group at the first insertion attempt was greater than that of the standard index finger insertion technique (98% vs. 78%; p=0.001), and less time for insertion was required (11.88±3.62 s vs. 25.98±10.92 s; p<0.0001). The incidence of post-operative sore throat was lower (15% vs. 38.34%; p=0.0067), and blood staining on the PLMA was less (11.7% vs. 45%; p<0.0001). The increase in the mean arterial pressure was more in the standard technique group. Conclusion:The 90° rotation technique has a higher success rate at first insertion attempt for inserting the ProSeal LMA than the index finger insertion technique with less time for insertion and fewer side effects.Keywords: LMA insertion techniques, 90° rotation technique, airway management, laryngeal masks, ProSeal LMA Amaç: Proseal laringeal maske havayolunun (PLMA) takılma-sında 90° rotasyonla takma tekniğinin başarı oranının standart işaret parmağıyla takma tekniğinden daha yüksek olduğu bildirilmektedir. Bu çalışmanın amacı 90° rotasyonla takma tekniğini ve standart teknikleri, takma girişimi sayısı, işlemin süresi ve komplikasyonlar açısından değerlendirmek ve karşı-laştırmaktır.Yöntemler: Yüz yirmi yetişkin hasta standart teknik grubu veya rotasyon tekniği grubuna, her grupta 60 hasta olacak şekilde dağıtıldı. Rotasyon tekniği grubunda, PLMA kafı tamamen hastanın ağzına parmak sokulmadan orta hat yaklaşımıyla yerleştirildi, hastanın dilinin çevresinde saat yönü tersine 90° döndürüldü, ilerletildi ve direnç hissedilene kadar geri dön-dürüldü. Bulgular:Rotasyon tekniği grubunun ilk girişimdeki başa-rı oranı standart işaret parmağıyla takma tekniğinden daha yüksekti (%98'e karşı %78; p=0,001) ve işlem süresi daha kısaydı (11,88±3,62 sn'ye karşı 25,98±10,92 sn; p<0,0001). Ameliyat sonrası boğaz ağrısı insidansı daha düşüktü (%15'e karşı %38,34; p=0,0067) ve PLMA'da kan lekesi daha azdı (%11,7'ye karşı %45; p<0,0001). Ortalama arter basıncındaki artış, standart teknik grubuna göre daha fazla bulundu.Sonuç: Proseal LMA'nın takılması açısından, 90° rotasyon tekniğinin ilk girişimdeki başarı oranı işaret parmağıyla takma tekniğinden daha yüksekti. İşlem süresi daha kısaydı ve yan etkileri daha azd...

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Comparison of Two Insertion Techniques of ProSeal™ Laryngeal Mask Airway

Abstract: The rotational technique is more successful than the standard technique and is associated with less pharyngeal mucosal trauma, as evidenced by a lower incidence of sore throat and mucosal bleeding.

Cited by 43 publications

References 14 publications

A prospective randomised comparison of two insertion methods for i-gel^™placement in anaesthetised paralysed patients: standard vs rotational technique

A prospective randomised comparison of two insertion methods for i-gel^™placement in anaesthetised paralysed patients: standard vs rotational technique

Insertion of the ProSeal™ laryngeal mask airway is more successful with the 90° rotation technique

A Prospective Randomised Clinical Trial for the Comparison of Two Techniques for the Insertion of Proseal Laryngeal Mask Airway in Adults-Index Finger Insertion Technique versus 90° Rotation Technique

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Comparison of Two Insertion Techniques of ProSeal™ Laryngeal Mask Airway

Abstract: The rotational technique is more successful than the standard technique and is associated with less pharyngeal mucosal trauma, as evidenced by a lower incidence of sore throat and mucosal bleeding.

Cited by 43 publications

References 14 publications

A prospective randomised comparison of two insertion methods for i-gel™placement in anaesthetised paralysed patients: standard vs rotational technique

A prospective randomised comparison of two insertion methods for i-gel™placement in anaesthetised paralysed patients: standard vs rotational technique

Insertion of the ProSeal™ laryngeal mask airway is more successful with the 90° rotation technique

A Prospective Randomised Clinical Trial for the Comparison of Two Techniques for the Insertion of Proseal Laryngeal Mask Airway in Adults-Index Finger Insertion Technique versus 90° Rotation Technique

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A prospective randomised comparison of two insertion methods for i-gel^™placement in anaesthetised paralysed patients: standard vs rotational technique

A prospective randomised comparison of two insertion methods for i-gel^™placement in anaesthetised paralysed patients: standard vs rotational technique