Study Objective: To compare the ease of insertion of the laryngeal mas
k airway (LMA) by two methods. Design: Prospective, randomized study.
Setting: Operating room of a university-affiliated teaching hospital.
Patients: 350 ASA I, II, and III patients undergoing general anesthesi
a, in whom use of the LMA was not contraindicated. Interventions: With
all routine monitors in place and after the induction of anesthesia w
ith propofol, we compared the ease of insertion of the LMA in the two
groups of 175 patients each. The timing of insertion was made on clini
cal grounds. In one group, the LMA was inserted with the cuff fully de
flated, in the other group, the cuff was partially inflated (i.e., fil
led with half the recommended air in the cuff). When correct placement
of the mask was not successful by one method, the other method was tr
ied and the insertion graded in the same manner. Measurements and Main
Results: The ease of insertion of the LMA was graded by the user on a
scale of 1-4. Insertion of the LMA with the cuff partially inflated w
as significantly more successful (97.7%) than when the cuff was fully
deflated (92%) (p < 0.05). When correct placement of the mask was not
possible with the cuff fully deflated, partial inflation resulted in c
orrect placement. Conclusions: Inserting the LMA with the cuff partial
ly inflated is likely to be more successful than with the cuff fully d
eflated. When it is not possible to insert the LMA with the cuff fully
deflated, partial inflation before insertion may result in correct pl
acement.