Does a fibreoptic scoring system reliably assess the position of laryngeal mask airway devices (LMA, FLMA, ILM) in anaesthetised adult patients?
The fibreoptic scoring system has excellent interobserver reliability for assessing laryngeal mask airway devices, showing better positioning for LMA and FLMA compared to ILM.
We determined the interobserver reliability of a fibreoptic scoring system for assessing the position of the laryngeal mask airway (LMA), the flexible laryngeal mask airway (FLMA) and the intubating laryngeal mask airway (ILM). We also compare fibreoptic position between the devices. Thirty anaesthetised adult patients were studied in random order in a triple crossover manner. Two observers blinded to each others findings scored the fibreoptic position as follows: 4, only vocal cords visible; 3, vocal cords plus posterior epiglottis visible; 2, vocal cords plus anterior epiglottis visible; 1, vocal cords not seen. Interobserver reliability was examined using intraclass correlation coefficient (ICC). Interobserver reliability was graded as excellent for the LMA (ICC = 0.89), FLMA (ICC = 0.87) and ILM (ICC = 0.79). Fibreoptic scores were higher for the LMA and FLMA compared with the ILM (both p < 0.001). We conclude that interobserver reliability for the fibreoptic scoring system is excellent for the LMA, FLMA and ILM. Fibreoptic position is better for the LMA and FLMA compared with the ILM. Fibreoptic scoring has potential utility for research and clinical practice with laryngeal mask devices.
Keller et al. (Wed,) studied this question.