COMPARISON OF STANDARD AND ROTATIONAL TECHNIQUE FOR EASE OF INSERTION OF LARYNGEAL MASK AIRWAY (LMA) IN ADULT PATIENTS

Abstract

Background: Laryngeal mask airway (LMA) is widely used for airway management during short elective surgical procedures. Ease of insertion is essential for successful placement and minimizing complications. Various insertion techniques have been described, including the standard Brain’s technique and the rotational technique, with variable success rates reported in the literature. This study compared the frequency of ease of LMA insertion using standard and rotational techniques in local settings. 

Objective: To compare the frequency of ease of LMA insertion using standard and rotational techniques in adult female patients undergoing laparoscopic gynecological surgery.

Study Design: Prospective randomized controlled trial.

Setting: Department of Anesthesiology, Hameed Latif Hospital, Lahore.

Duration: Four months w.e.f. 20-01-2025 to 20-05-2025

Methodology: A total of 124 adult female patients aged 20–40 years, ASA I–II, scheduled for laparoscopic gynecological surgery were enrolled. They were divided into two groups: Group A and Group B, with 62 patients in each group. Participants were randomly assigned using a lottery method. Group A underwent LMA insertion using the standard technique, while Group B underwent insertion using the rotational technique. Ease of insertion was defined as successful placement of LMA on the first attempt. Time taken for insertion and incidence of complications were also recorded. Data were analyzed using SPSS version 25. Chi-square test and independent sample t-test were applied, with p≤0.05 considered statistically significant.

Results: Both groups were comparable at baseline (p>0.05). Ease of insertion was achieved in 54 patients (87.1%) in standard group and 58 patients (93.5%) in rotational group (p=0.224). Mean insertion time was 8.03±4.70 seconds in standard group versus 8.73±4.35 seconds in rotational group (p=0.395). Sore throat occurred in 13 (21.0%) and 11 (17.7%) patients respectively (p=0.649). Dysphagia was reported in 0 vs. 1 patient (p=1.000). No intraoperative complications (desaturation, laryngospasm, mucosal trauma) were recorded in either group.

Conclusion: Both standard and rotational techniques for LMA insertion demonstrate high success rates with comparable outcomes. The rotational technique does not confer significant advantage over standard technique in this low-risk patient population.