Gum elastic bougie versus introducer tool for insertion of Pro-Seal LMA: A comparative study

Background: ProSeal LMA is useful in preventing aspiration of gastric contents. The correct position of its oesophageal lumen is important to prevent entry of these contents into the pharynx. In this randomized, controlled prospective study, we compared two techniques for insertion of ProSeal LMA. Patients & Methods: Sixty patients between 17-65 years, of either gender, undergoing minor surgical procedures were randomly allocated to have ProSeal LMA inserted either by Introducer tool (Group-IT, n = 30) or a gum elastic bougie (Group-GEB, n = 30). Results: The success rate for insertion of ProSeal LMA at first attempt was higher in the GEB-group compared to IT-group (96.67% vs 80%) although overall success was similar in both groups. The frequency of obtaining a Grade 1 or 2 fibreoptic view through the airway tube was significantly higher in the GEB-group (100%) than IT-group (86.2%). Successful placement of ProSeal LMA took longer time with the GEB (40.8 ± 13.6 s )compared to IT( 19.8 ± 12.4 s). Airway seal pressure, attempts at Ryle's tube insertion and incidence of complications was similar in the two groups. Conclusion: GEB-guided insertion achieves better placement and in the first attempt as compared to Introducer tool-guided insertion but takes a longer time.