Comparison of standard versus 90° rotation technique for LMA Flexible insertion: a randomized controlled trial

BackgroundInsertion of a flexible laryngeal mask airway (LMA Flexible) is known to be more difficult than that of a conventional laryngeal mask airway. The 90 degrees rotation technique can improve the success rate with a conventional laryngeal mask airway but its effect with the LMA Flexible remains unknown. We assessed whether the 90 degrees rotation technique increased the first-attempt success rate of LMA Flexible insertion versus the standard technique.MethodsIn total, 129 female patients undergoing breast surgery were analyzed. The primary endpoint was success at the first attempt. The insertion time, number of trials, number of manipulations required, and oropharyngeal leak pressure were also evaluated. Heart rate and mean blood pressure were recorded 1min before and 1min after insertion. Blood staining on the LMA Flexible after removal and postoperative sore throat were checked.ResultsThe first-attempt success rates were comparable between the groups (93% vs. 98.3%, P=.20). The insertion time, number of trials and manipulations, hemodynamic variables, and complications, such as blood staining and sore throat, did not differ between the groups.ConclusionsThe 90 degrees rotation technique is a good alternative to the standard technique for insertion of the LMA Flexible.Trial registrationClinicalTrials.gov (NCT03028896). It was registered retrospectively at Jan 19th, 2017.