British Journal of Anaesthesia, Vol 80, Issue 5 617-620, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia
T. Asai, J. Neil and M. Stacey
We studied 20 patients, in a randomized, cross-over study, to determine if
manual in-line stabilization of the head and neck altered the ease of
insertion of the laryngeal mask and its correct positioning. After
induction of anaesthesia and neuromuscular block, the laryngeal mask was
inserted and adequacy of ventilation assessed while the patient's head and
neck were placed in the Magill and manual in-line positions, in turn. Ease
of insertion of the mask was assessed using a 10-cm visual analogue scale
(VAS) and position using a fibreoptic bronchoscope. Time for insertion of
the mask was measured. The laryngeal mask was inserted and adequate
ventilation obtained at the first attempt in all 20 patients in the Magill
position and in 19 of 20 patients in the manual in-line position. Insertion
was always more difficult (P << 0.001; 95% CI for difference in VAS
20-55 mm) and time for insertion longer (P << 0.001; 95% CI for
difference 4.9-11.9 s) in the manual in-line position compared with the
Magill position. The incidence of a suboptimal position was significantly
higher for the manual in-line position (seven patients) than for the Magill
position (15 patients) (P < 0.005). We conclude that in paralysed
patients, manual in-line stabilization of the head and neck made insertion
of the laryngeal mask and its correct positioning more difficult.
CLINICAL INVESTIGATIONS
Ease of placement of the laryngeal mask during manual in-line neck stabilization
Department of Anaesthesiology, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi City, Osaka 570, Japan; Department of Anaesthetics and Intensive Care Medicine, University Hospital of Wales, Heath Park, Cardiff, CF4 4XN; Llandough Hospital NHS Trust, Penlan Road, Penarth CF64 2XX
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