Randomized clinical trial of trapezius squeezing test and jaw thrust as optimal indicators for Laryngeal mask airway insertion in adults under propofol anesthesia

Abstract

Background: Laryngeal mask airway insertion requires a certain depth of anesthesia that blunts the airway reflexes. We compared the effectiveness of the trapezius squeezing test with that of the jaw thrust test as clinical indicators of adequate condition for laryngeal mask airway insertion in adults under propofol anesthesia.Methods: In this randomized study, seventy adult patients undergoing surgery with general anesthesia maintained with laryngeal mask airway were randomly allocated to the group T (trapezius squeezing, n = 35) or the group J (jaw thrust, n = 35). The laryngeal mask airway was inserted immediately after the loss of response to trapezius squeezing or jaw thrust. We recorded successful and unsuccessful attempts. An unsuccessful attempt was defined as development of coughing, SPO2 < 90%, body movements during or within one minute of laryngeal mask airway insertion and failed insertion of laryngeal mask airway. Preparation time for laryngeal mask airway insertion, blood pressure, and heart rate were recorded.Results: The incidence of successful attempts was significantly higher in the group T than in the group J (p-value = 0.002). The time taken for preparation and insertion of laryngeal mask airway, arterial blood pressure and heart rate were comparable in both the groups.Conclusion: This study has demonstrated that the trapezius squeezing test is a superior indicator of an adequate condition for laryngeal mask airway insertion compared to the jaw thrust test in adults.

Comparison of Mean Insertion Time of Supraglottic Airway Device in Children Followed by Trapezius Squeeze Test Versus Jaw Thrust

“…Jaw thrust induces sympathetic response regardless of the magnitude of force applied. 13 Trapezius squeeze is widely used by neurologists to assess the neurological status of patients. However, it is not commonly used to assess the depth of anaesthesia.…”

Evaluation of ketamine versus midazolam as co-induction agents with propofol for laryngeal mask airway insertion in children

“…It is fairly straightforward and safe to utilize over a wide range of surgical specialties [1]. The insertion of LMA requires adequate anesthetic depth for relaxing the jaw muscles and the inserted LMA to be tolerated without unwanted coughing, gagging, breath-holding or involuntary movement and there are many induction agents were attempted to promote smooth insertion of LMA [2].…”