Incidence of insertion difficulty using Proseal LMA and the efficacy of recommended insertion maneuvers

BACKGROUND: According to the instruction manual, the sniffing position (SP) and the slight lateral approach (SLA) are the recommended insertion methods using Proseal laryngeal mask airway (PLMA). However, the efficacy of these methods has not been assessed. METHODS: The incidence and the reason of the insertion with difficulty were assessed in 50 adult patients. And then, the efficacy of these methods in the patient with insertion difficulty was studied. RESULTS: Establishment of the airway was unsuccessful in 10 patients at first attempt. The commonest reason of unsuccessful attempt was failure to slide PLMA into the pharynx. The insertion was successful and patent airway was obtained using Full-SP and SLA in 8 of the 10 patients. CONCLUSIONS: It was suggested that Full-SP and SLA were useful to place PLMA in patients with insertion difficulty.