Comparison of Three Methods for Laryngeal Mask Airway Insertion in Adults: Standard, Lateral and Rotational

Determination of an optimal Laryngeal Mask Airway (LMA) insertion technique is of great importance as unsuccessful prolonged insertion and multiple attempts are associated with adverse respiratory effects and trauma. The purpose of this study was to compare the ease of insertion of LMA using the standard approach with lateral and rotational techniques. 150 adult patients undergoing general anesthesia using LMA were randomized into one of the three mentioned techniques: standard, rotational and lateral. The time for LMA insertion, number of LMA insertion attempts and LMA insertion success rate were noted for all patients. Demographic characteristic of patients between three groups did not have significant difference. Patient movement and time for LMA insertion and time for LMA insertion was significantly less in lateral technique (P<0.001). The overall success rate for LMA insertion between three groups was not of significant difference (P=0.06); however, there was a positive trend toward the lateral insertion group. Lateral technique is practically easy, does not require pushing toward the back of the mouth and consequently is associated with the least complications. Therefore, it seems that the 90 degrees rotational or lateral techniques might be considered as the best ways for LMA insertion.