Comparison of Standard and Lateral Methods of Laryngeal Mask Airway Insertion in the Management of Pediatrics Airway

The Laryngeal Mask Airway (LMA) has traditionally become an alternative device for airway management. This clinical trial compared two standard and lateral techniques in inserting laryngeal masks in pediatric airway management. This single-blind clinical trial study was conducted on pediatrics aged 2-6 years who were candidates for elective inguinal herniorrhaphy with ASA I and II under general anesthesia. The pediatrics were randomly assigned to either the standard or lateral methods according to the random number table. The time required to insert LMA and airway pressure as well as the number of attempts to insert in both groups were measured. Data analysis was performed using SPSS version 25; the significance level was less than 0.05. Chest movement and mean airway pressure had no significant difference in both groups (p>0.05). The mean LMA insertion time in the lateral and standard methods was 22.94±7.89 and 65±15.27 seconds, respectively (p=0.001). There was no case of mucosal damage in the lateral method, but ten children had mucosal damage in the standard technique (p=0.001). In the lateral method, LMA was inserted for the first time in 32 pediatrics (94.1%) and two pediatrics (5.9%) in the second time but in the standard group, LMA was inserted in the second time in 11 pediatrics (32.4%) (p=0.006). The lateral method for inserting LMA is practically easy, requires less effort, and has the least complications. Another advantage of the lateral method compared to the standard technique is that inserting a finger into the pharyngeal cavity is unnecessary.