19584
document
Gum elastic bougie-guided insertion of the ProSeal Laryngeal Mask Airway . We tested the hypothesis that gum elastic-bougie-guided insertion of the ProSeal Laryngeal Mask Airway is more frequently successful than introducer tool guided insertion after failed digital insertion . One hundred anaesthetized patients ( ASA 1-2 , aged 18 to 80 years ) were randomized for the second insertion attempt using either the gum elastic bougie-guided or introducer tool techniques . The bougie-guided technique involved priming the drain tube with the bougie , placing the bougie in the oesophagus using laryngoscope guidance , digital insertion along the palato-pharyngeal curve , and bougie removal . The introducer tool technique involved attaching the introducer tool , single-handed rotation along the palatopharyngeal curve , and introducer tool removal . Failed insertion was classified as ( i ) failed passage into the pharynx , ( ii ) malposition , or ( iii ) ineffective ventilation . Any blood staining was documented . Insertion was more frequently successful ( 50/50 vs 15/50 , P=0.0002 ) and faster ( 35+/-17 s vs 54+/-45 s , mean+/-SD , P=0.006 ) with the bougie-guided technique . All failed insertions with the introducer tool technique were successful with the bougie-guided technique . The aetiology of failed insertion was similar for the digital and introducer tool techniques in 94 % ( 33/35 ) of patients . There was no blood staining on the bougie , laryngoscope or introducer tool at removal , but blood staining was more common on the ProSeal Laryngeal Mask Airway with the introducer tool technique ( 9/50 vs 2/50 , P=0.03 ) . We conclude that the gum elastic bougie-guided insertion has a higher success rate and causes less trauma than the insertion tool insertion technique after failed digital insertion of the ProSeal Laryngeal Mask Airway .
19585
Intervention_Physical
Gum elastic bougie-guided insertion
19586
Intervention_Physical
gum elastic-bougie-guided insertion
19587
Intervention_Surgical
second insertion attempt using either the gum elastic bougie-guided or introducer tool techniques .
19588
Intervention_Physical
bougie-guided technique
19589
Intervention_Physical
introducer tool technique
19590
Intervention_Physical
gum elastic bougie-guided insertion
19591
Outcome_Physical
blood staining
19592
Outcome_Other
Insertion
19593
Outcome_Other
frequently successful
19594
Outcome_Other
failed insertions
19595
Outcome_Other
aetiology of failed insertion
19596
Outcome_Other
blood staining
19597
Outcome_Physical
blood staining
19598
Participant_Sample-size
One hundred
19599
Participant_Age
18 to 80 years