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The 90° rotation technique is known to improve the success rate of conventional LMA but its effect in LMA FlexibleTM is not known. We tried to find if 90° rotation technique could increase the first attempt success rate of the insertion of LMA FlexibleTM compared to standard technique.
One hundred and sixteen adult patients undergoing breast surgery were randomized to the two insertion techniques. The ease of insertion was assessed by the success rate at the first attempt. Heart rate and mean blood pressure were recorded 1 min before and 1 min after insertion. Postoperative complications were checked.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| standard | No Intervention | In the neck flexed and the head extended position, hold mask like a pen with the index finger placed anteriorly at the junction of the cuff and tube, push the mask backwards maintaining pressure against the palate until resistance is felt. | |
| rotational | Experimental | After insertion of the entire cuff inside the mouth, the LMA FlexibleTM was rotated counter-clockwise through 90° and was advanced through the right side of the tongue until the resistance was felt, and then was returned back in the hypopharynx. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 90° rotational technique | Procedure | the LMA FlexibleTM was rotated counter-clockwise through 90° |
|
| Measure | Description | Time Frame |
|---|---|---|
| First Attempt Success Rate | the first attempt success rate of insertion of LMA FlexibleTM | at induction |
| Measure | Description | Time Frame |
|---|---|---|
| Insertion Time | time from passed mouth of the device to the effective ventilation after inflation of the cuff | at induction |
| Oropharyngeal Leak Pressure | audible leak during manual ventilation at mouth |
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Inclusion Criteria:
Exclusion Criteria:
Breast surgery
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31170926 | Result | Koo BW, Oh AY, Hwang JW, Na HS, Min SW. Comparison of standard versus 90 degrees rotation technique for LMA Flexible insertion: a randomized controlled trial. BMC Anesthesiol. 2019 Jun 7;19(1):95. doi: 10.1186/s12871-019-0773-z. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Standard | In the neck flexed and the head extended position, hold mask like a pen with the index finger placed anteriorly at the junction of the cuff and tube, push the mask backwards maintaining pressure against the palate until resistance is felt. |
| FG001 | Rotational | After insertion of the entire cuff inside the mouth, the LMA FlexibleTM was rotated counter-clockwise through 90° and was advanced through the right side of the tongue until the resistance was felt, and then was returned back in the hypopharynx. 90° rotational technique: the LMA FlexibleTM was rotated counter-clockwise through 90° |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Standard | In the neck flexed and the head extended position, hold mask like a pen with the index finger placed anteriorly at the junction of the cuff and tube, push the mask backwards maintaining pressure against the palate until resistance is felt. |
| BG001 | Rotational |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | First Attempt Success Rate | the first attempt success rate of insertion of LMA FlexibleTM | Posted | Count of Participants | Participants | at induction |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Standard | In the neck flexed and the head extended position, hold mask like a pen with the index finger placed anteriorly at the junction of the cuff and tube, push the mask backwards maintaining pressure against the palate until resistance is felt. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Bon-wook Koo | SNUBH | +82-10-7227-1379 | 31 | tendong2@gmail.com |
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| at induction |
| Number of Participants With Blood Staining on the Laryngeal Mask Airway | Number of Participants with blood staining on the laryngeal mask airway. | post op 1min |
After insertion of the entire cuff inside the mouth, the LMA FlexibleTM was rotated counter-clockwise through 90° and was advanced through the right side of the tongue until the resistance was felt, and then was returned back in the hypopharynx. 90° rotational technique: the LMA FlexibleTM was rotated counter-clockwise through 90° |
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
|
|
| Secondary | Insertion Time | time from passed mouth of the device to the effective ventilation after inflation of the cuff | Posted | Mean | Standard Deviation | seconds | at induction |
|
|
|
| Secondary | Oropharyngeal Leak Pressure | audible leak during manual ventilation at mouth | Posted | Mean | Standard Deviation | cmH2O | at induction |
|
|
|
| Secondary | Number of Participants With Blood Staining on the Laryngeal Mask Airway | Number of Participants with blood staining on the laryngeal mask airway. | Posted | Count of Participants | Participants | post op 1min |
|
|
|
| 0 |
| 63 |
| 0 |
| 66 |
| 0 |
| 66 |
| EG001 | Rotational | After insertion of the entire cuff inside the mouth, the LMA FlexibleTM was rotated counter-clockwise through 90° and was advanced through the right side of the tongue until the resistance was felt, and then was returned back in the hypopharynx. 90° rotational technique: the LMA FlexibleTM was rotated counter-clockwise through 90° | 0 | 66 | 0 | 66 | 0 | 66 |
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