Background and objective: The laryngeal mask airway (LMA) is used as an alternative to endotracheal intubation in elective surgeries. Malpositioning can lead to hypoventilation, gastric insufflation, regurgitation and aspiration. This study is designed to assess and compare proper placement of classic LMA (cLMA) and flexible LMA (FLMA) using clinical criteria and fibreoptic assessment. Methodology: 200 consented adult patients (cLMA -100, FLMA -100), of American society of anaesthesia physical status I and II undergoing elective surgery under general anaesthesia were included in the study. LMA was inserted by standard technique after induction with fentanyl and propofol. Position was confirmed by clinical criteria and fibre optic assessment (grade 1 to 5). LMA was removed and looked for any blood on it after surgery. Malpositioning, failure and complications of LMA placement were noted. Results: Demographic characteristics were comparable between the two groups. Number of insertion attempts were similar in both the groups (P=0.224). Mean time taken for insertion was significantly longer with flexible LMA (cLMA - 14.13 ± 8.00, FLMA - 23.39 ± 17.56). Clinical criteria of proper placement were fulfilled in all patients in both the groups. Fibreoptic grading of glottic view between the two groups were similar (P=0.731) Hemodynamic response to LMA insertion, incidence of leak (cLMA 6%, FLMA 4%, P = 0.748) and blood on LMA (cLMA 2%, FLMA 3%, P=0.765) were similar in two groups. Conclusion: Flexible LMA requires more time for insertion compared to classic LMA. However the final cuff position of flexible LMA is similar to classic LMA, hence can be considered for various head and neck surgeries.

Laryngeal,LMA, Glottic, Hemodynamic Process