Background:The standard recommended insertion technique for LMA Classic™ requires the insertion of index finger into the oral cavity. Several anesthesiologists are reluctant to do this. We conducted this study to evaluate the modified technique of insertion of LMA Classic™ (not requiring insertion of fingers into the patient's mouth) against the standard index finger insertion technique.Materials and Methods:This prospective, randomized, comparative study was conducted on 200 consenting patients. Patients suitable for anesthetic with LMA Classic™ were randomized to standard technique group (standard insertion technique) and modified technique group (technique not requiring digital intraoral manipulation). Laryngeal mask airway (LMA) was inserted by five designated anesthesiologists. Anesthetic protocol was standardized. Time taken to achieve an effective airway, ease of insertion, glottic view obtained through LMA, and incidence of sore throat were assessed.Results:Patient characteristics and duration of surgery were comparable between the groups. Time to achieve an effective airway was comparable [18.5 (8) s with standard technique and 19.7 (10) s with modified technique; data are mean (standard deviation)]. Ease of insertion (92 easy with standard technique and 91 easy with modified technique), success rate (99% in both the groups), glottic view with fiberoptic bronchoscope, and sore throat incidence (six patients with standard technique and eight patients with modified technique) were comparable. The first attempt success rate was significantly higher with the standard technique (98 patients in the standard technique group and 91 patients in the modified technique group).Conclusions:LMA Classic™ can be inserted successfully without the need to insert index finger into patient's mouth, though the first attempt success rate is higher with the standard technique.

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Background and Aims: Inadvertent perioperative hypothermia defined as the perioperative core temperature of <36°C is a common problem in day-to-day anesthesia practice. It is not clear from the literature whether prewarming, that is, initiation of convective warming of the patient at a time point prior to induction of anesthesia is superior or comparable to cowarming, that is, initiation of convective warming simultaneously with induction of anesthesia. We conducted this study to find whether cowarming is as good as prewarming in preventing the occurrence of intraoperative hypothermia. Material and Methods: Sixty-two adult patients undergoing major abdominal surgery under general anesthesia were randomized to receive either prewarming for 60 min at 40° C or cowarming using the Level 1® Equator ® body warmer. All patients who were prewarmed also received cowarming during induction of anesthesia. In both the groups, convective warming was continued during intraoperative period. Incidence of intraoperative hypothermia, core, and peripheral body temperatures were compared between the two groups. Results: Among 27 patients in each group who completed the study core temperature decreased to <35° C toward the end of surgery in 17 patients in group prewarming [mean (SD) 34.59 (1.17° C)] and 18 patients in group cowarming [mean (SD) 34.31 (1.34° C)]. The incidence of intraoperative hypothermia and the core temperature at the end of surgery were comparable ( P = 0.42). Conclusion: Cowarming is as effective as prewarming to prevent intraoperative hypothermia.