Comparison of Gum Elastic Bougie Guided Insertion of The Proseal Laryngeal Mask Airway with Digital and Introducer Tool Techniques

Abstract

Introduction: Gum Elastic Bougie (GEB) guided technique of insertion of Proseal Laryngeal Mask Airway (PLMA) was compared with the conventional digital manipulation and introducer tool (IT) technique in adults undergoing elective surgery under general anesthesia.
Material and Methods: Ninety American Society of Anesthesiologists (ASA) grade 1 and 2 adult patients were randomly divided into three groups. In Group A (n=30) LMA Proseal was inserted by using index finger (Digital technique); Group B (n=30) - LMA Proseal was inserted by using an Introducer Tool (IT); Group C (n=30) - LMA Proseal was inserted by using Gum Elastic Bougie (GEB). Success rate of LMA placement and time taken to insert LMA using these three techniques were compared. Any visible staining on GEB, IT, laryngoscope or LMA Proseal was noted at removal. Any airway trauma and postoperative airway complications were recorded.
Results: First attempt PLMA insertion success rate was highest with GEB (100 %). Insertion of PLMA using GEB guided technique (23.30 ± 4.99 seconds) was faster than IT (25.97 ± 9.74 seconds) and digital technique (29.40 ± 13.95 seconds). Postoperative airway morbidity was least with GEB.
Conclusion: Gum Elastic Bougie guided insertion technique of PLMA is a better alternative to standard Digital and IT technique.