# A Prospective Randomized Study to Compare Standard to Reverse Insertion Techniques of Classic Laryngeal Mask Airway (LMA) in Pediatric Patients

## TL;DR

This study compares two techniques for inserting a laryngeal mask airway in children and finds the standard method is faster and safer.

## Contribution

The study provides empirical evidence on insertion techniques for LMA in pediatric patients, focusing on time and complications.

## Key findings

- Standard technique had a 93.3% first-attempt success rate compared to 86.7% for the reverse technique.
- Standard insertion was significantly faster, with a mean time of 16.28 seconds versus 18.40 seconds for the reverse method.
- Complication rates were lower with the standard technique, though not statistically significant.

## Abstract

Introduction

The laryngeal mask airway (LMA) has emerged as a viable option for managing airways. It is an alternative rescue technique for both anticipated and unanticipated difficult airways in both elective and emergency settings.

Methods

In our study, 120 patients were divided into two groups: Group S (n=60), standard technique for classic LMA (c-LMA) insertion, and Group R (n=60), reverse technique for classic LMA insertion. The number of insertion attempts was recorded. Insertion was considered easy if there was successful placement on the first attempt with or without maneuvers. We also noted the total time for the successful placement of the airway.

Results

In Group S, successful LMA placement on the first attempt was done in 93.3% of the patients, compared to 86.7% of the patients in Group R, though it was not statistically significant (p=0.5265). The mean time required to secure the airway in Group S was 16.28±1.93 seconds, whereas in Group R, it was 18.40±2.92 seconds (p<0.0001). The difference in hemodynamic parameters was nonsignificant (p≥0.05). In Group S, incidences of complications were lower compared to Group R, but it was not statistically significant (p>0.05). Irrespective of the technique used, the failure rate was zero.

Conclusion

Considering the shorter insertion time, along with the lower complication rates, the standard technique may be regarded as the preferred method of LMA insertion over the reverse technique.