Fiberoptic assessment of laryngeal mask airway placement: a comparison of blind insertion and insertion with the use of a laryngoscope

Background and objectives: This study aims to compare the frequency of ideal anatomic placement of the Laryngeal Mask Airway (LMA) using the traditional blind insertion approach with one where placement was facilitated by the use of a laryngoscope. Laryngeal Mask Airway is a supraglottic device in providing general anaesthesia. Methods: A prospective comparison of 60 patients divided into 2 groups (30 with the blind technique and 30 with the direct technique) were evaluated with 2 airway assessment methods, Wilson and Mallampati. We also considered whether there was a relationship between these criteria and the successful placement into an ideal position. Other variables were considered, including hemodynamics. Five placement visual ordinals were used to grade the LMA position. Results: There was no statistically significant difference between group 1 and group 2 (P=0.279) in terms of Campbell category. There was no statistically significant relation between Wilson airway score or Mallampati class and Campbell category (p=0.633 and 0.239 respectively). There was no statistically significant difference in systolic and diastolic BP at 1, 2 and 5 min post insertion between the two groups, but there was a statistically significant difference in 1 and 2 minute post insertion pulse rate (P=0.004). Conclusion: Blind insertion technique is easier and simpler method for insertion of LMA and has a reasonable success during insertion, so it is recommended to be used. © 2009, Springer.