Study of effect of head elevation in PROSEAL laryngeal mask airway insertion at a tertiary hospital

Background & Aims: Proseal Laryngeal Mask Airway (PLMA) is a supra-glottic airway device that prevents gastric insufflation and pulmonary aspiration. In the present study, we intend to determine the effect of head elevation in PLMA insertion. Methodology: The present study was a single-center, comparative, interventional study, conducted in patients of 18-60 years of age, either gender, American Society of Anaesthesiologists (ASA) grade I-II, patients posted for elective surgical procedures under general anaesthesia. 123 adult patients were randomized into three groups using a random number table. Group C: No head elevation (No pillow), Group LP: 4 cm head elevation (4 cm pillow), and Group HP: 8 cm head elevation (8 cm pillow). Results: PLMA insertion at first attempt was successful in 30 patients (73.17%) in Group C, 40 patients (97.56%) in Group LP & 22 patients (53.66 %) in Group HP, the difference was statistically significant (P <0.001). The mean insertion time of LMA in Group C, Group LP, and Group HP was found to be 21.90 ± 4.48s, 16.12 ± 5.35s, and 25.14 ± 8.79s respectively which was significantly less in Group LP when compared with Group C and Group HP (P< 0.001). The ncidence of blood staining on PLMA was significant in Group HP (20 patients) as compared to Group C (3 patients) & Group LP (2 patients), the difference was statistically significant (P <0.001). Conclusion: A head elevation by a pillow of height of 4 cm was effective for PLMA insertion in adult patients when compared with an 8 cm pillow.