Incidence of postoperative pharyngeal complications after using a new laryngeal mask airway supreme insertion method

Abstract

In this study, a new insertion method was used to reduce the intracuff pressure of laryngeal mask airway (LMA), and its impact on pharyngeal complications was compared with that of patients under routine care. Sixty women who underwent general anesthesia with LMA for hysteroscopic surgery were randomly allocated into routine care and intervention groups. In the routine care group, the LMA was inserted according to the LMA practice manual. In the intervention group, after insertion with standard manoeuvre, the LMA was withdrawn several millimeters to reduce hypopharynx compression, and the intracuff pressure was then fine-tuned to the minimum effective pressure through volume titration. Pharyngeal complications were assessed at 1, 2, 6 and 24 h postoperatively. Composite pharyngeal complications, pharyngeal complications at different time points and LMA intracuff pressures were compared. The study ultimately included 57 patients. The incidence of composite pharyngeal complications in 24 h was lower in the intervention group than in the routine care group (10.3% vs. 32.1%, P = 0.044). The differences in the incidence of pharyngeal complications at different time points between and within groups were marginally significant (P = 0.052 and 0.060, respectively). Mean LMA intracuff pressure was lower in the intervention group versus the routine care group (11.28 ± 4.22 vs. 68.89 ± 22.53 cmH2O, P < 0.001). This new insertion method achieved the minimum effective intracuff pressure for LMA and significantly decreased the incidence of postoperative pharyngeal complications. Registration clinical trial: ChiCTR2300078350