Comparative analysis of laryngeal mask placement techniques during combined anesthesia in children

Objective. To evaluate the efficacy and safety of two methods of laryngeal mask (LM) placement during combined anesthesia in children.

Materials and methods. All patients were males (n=85), age median was 2 years old (1,5; 4). 2 clinical groups were created depending on the methods of mask placement during combined anesthesia. The standard LM insertion technique was applied in the 1st clinical group (n=44), LM insertion with 180° rotation was used in the 2nd clinical group (n=41).

Results. Conducted comparative analysis of hemodynamic parameters revealed significant differences indicating a less pronounced hemodynamic reaction in the 2nd clinical group (p=0.0016). Moreover, the total LM insertion time was 25.9 seconds (24.7; 28.8) (p=0.00017), first attempt time was 25.0 seconds (23.8; 26.5) (p=0.00065) and the number of attempts to inject it in group 2 were statistically significantly lower compared to the group using the standard technique (χ2 6.12, df=2, p=0.046 (p=0.0494, Fisher’s exact test)). However, none intergroup differences were found regarding oropharyngeal leak pressure, presence of blood on the cuff after LM extraction, and the presence of a sore throat the day after surgery.

Conclusion. Using of the laryngeal mask placement technique with 180° rotation showed greater efficiency, as evidenced by a 14.4% shorter LM placement time, which was statistically significantly lower – 25.9 sec. (24.7; 28.8), versus 30.6 sec. (27.4; 38.9) (p<0.05); 9.7% less time spent on the first attempt – 25.0 sec. (23.8; 26.5), versus 27.7 sec. (25.9; 29.1) (p<0.05); less attempts to install and less HR changing – 130.0 per min. (125.0; 135.0), versus 137.5 per min. (132.0; 145.0) (p<0.05) than using the standard LM placement method.

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