Comparison of lateral insertion technique of ClassicTM laryngeal mask airway along right versus left border of tongue in adults

Introduction

Appropriate placement of laryngeal mask airway (LMA) is crucial for successful ventilation during conduct of anaesthesia as well as during cardiopulmonary resuscitation. As LMA insertion is generally performed blindly, clinicians are always in search of an ideal technique that will provide a higher incidence of correct placement. We aimed at comparing the lateral insertion technique of Classic^TM LMA along the right border of the tongue with that of the left border in adults.  

Methodology

In this prospective randomised control study, we included 132 ASA I/II patients of either gender between 18 to 65 years and allocated into two groups. The operators were natural right-handed individuals. In Group R, LMA was inserted through the right border of the tongue and vice versa for Group L. We compared fibreoptic grading of laryngeal view, number of attempts, time taken for successful insertion, ease of insertion and complications.

Results

In our study the fibreoptic grading and the time taken in both the groups were similar. Ease of insertion and number of attempts was in favour of Group L. Even though the overall sore throat incidence was found to be less, it was significantly more in Group R than Group L.

Conclusion

The lateral technique of insertion of the Classic^TM LMA along either the right border or the left border of the tongue is comparable in terms of the fibreoptic grading and the time taken for successful insertion. However, left side technique is easier as per the operator, requires fewer number of attempts, has lesser incidence of sore throat after 2 hours.