A Study of Insertion of Lma Classic™ With and Without Digital Intraoral Manipulation in Anaesthetised Patients

Abstract

BACKGROUND Airway management is the most essential skill in anaesthesiology and inability to secure the airway is one of the most common reasons for major anaesthesia-related morbidities and mortalities. Laryngeal Mask Airway (LMA) has established role in modern anaesthetic practice. It is used for airway maintenance of spontaneously breathing patients who are undergoing elective short surgical procedures. The aim of the study is to evaluate the modified technique of insertion of LMA Classic™, which does not require the insertion of fingers into the patient's mouth as against the standard technique. MATERIALS AND METHODS Patients were randomly allocated to one of two equal-sized groups (n=100).Patients were randomised to standard technique group (standard insertion technique with digital intraoral manipulation) or modified technique group (modified insertion technique without digital intraoral manipulation) using computer generated random number table and sealed envelope technique. RESULTS Both the groups were comparable with respect to distribution of age (0.935), weight (0.733) and sex (0.606) and the p values were nonsignificance. As indicated in Table 2, the groups were comparable with respect to American Society of Anaesthesiologists Physical Status of the patients. The duration of the entire surgical procedure was similar in both the groups. This implies that the duration for which the LMA Classic TM was in situ in the patient was comparable between the two groups. The incidence of postoperative sore throat was comparable in both the groups. Five patients who had blood on the LMA Classic TM at the end of the procedure had sore throat, 4 had sore throat after 1 hour and 1 after 24 hours. The glottic view obtained with the fiberoptic bronchoscope passed through the LMA Classic TM was comparable in both the groups. Though more number of patients (68 patients) had grade 1 view in the modified group compared to standard group (58 patients), it was not significant statistically. CONCLUSION We conclude that LMA Classic TM can be inserted successfully without the need to insert finger into patient's mouth with results comparable to that obtained by the standard index finger insertion technique.