• Bon-Wook Koo, Ah-Young Oh, Jung-Won Hwang, Hyo-Seok Na, and Seong-Won Min.
• Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 137-82 Gumi-ro, Bundang-gu, Sungnam-si, Gyeonggi-do, 463-707, South Korea.
• BMC Anesthesiol. 2019 Jun 7; 19 (1): 95.

BackgroundInsertion of a flexible laryngeal mask airway (LMA Flexible) is known to be more difficult than that of a conventional laryngeal mask airway. The 90° rotation technique can improve the success rate with a conventional laryngeal mask airway but its effect with the LMA Flexible remains unknown. We assessed whether the 90° rotation technique increased the first-attempt success rate of LMA Flexible insertion versus the standard technique.MethodsIn total, 129 female patients undergoing breast surgery were analyzed. The primary endpoint was success at the first attempt. The insertion time, number of trials, number of manipulations required, and oropharyngeal leak pressure were also evaluated. Heart rate and mean blood pressure were recorded 1 min before and 1 min after insertion. Blood staining on the LMA Flexible after removal and postoperative sore throat were checked.ResultsThe first-attempt success rates were comparable between the groups (93% vs. 98.3%, P = .20). The insertion time, number of trials and manipulations, hemodynamic variables, and complications, such as blood staining and sore throat, did not differ between the groups.ConclusionsThe 90° rotation technique is a good alternative to the standard technique for insertion of the LMA Flexible.Trial RegistrationClinicalTrials.gov ( NCT03028896 ). It was registered retrospectively at Jan 19th, 2017.

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