Anestesia e Pesquisa Clínica
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Comparison of Metal Stylet, Small Tracheal Tube and Combined Introducer-Aided Insertions of the Flexible Reinforced Laryngeal Mask Airway with the Conventional Method: a Manikin Study

Takuro Sanuki, Hiroki Son, Shingo Sugioka, Naoe Komi, Motoko Hirokane, Naotaka Kishimoto, Yoshiko Mastuda and Junichiro Kotani

Purpose: The present study compared the conventional method (without any adjunct) and three different adjunct-aided methods (a metal stylet, a small tracheal tube, and a combined introducer) with regard to the time required for insertion of the flexible reinforced laryngeal mask airway (FLMA). We also surveyed participants’ views on the ease of FLMA insertion with each method.

Methods: Thirty dental students inserted the FLMA in a manikin by each method and the times required for insertion were measured. Subjects were asked to rate the ease of insertion with each method using a 100-mm visual analogue scale (VAS; from 0 mm = extremely easy to 100 mm = extremely difficult).

Results: Insertion time was significantly shorter with the small tracheal tube compared with the conventional method. However, insertion times with the metal stylet-aided insertion and the combined introducer-aided insertion were not significantly different as compared to the conventional method. With regard to the ease of insertion as rated using the 100-mm VAS, the dental students rated tracheal tube-aided insertion and combined introducer-aided insertion as being significantly easier, and the metal stylet-aided insertion as significantly more difficult than the conventional method.

Conclusions: The small tracheal tube-aided insertion and the combined introducer-aided insertion each appear to possess advantages over the conventional method. The small tracheal tube-aided insertion seems overall more favorable in terms of ease and time to insertion.