A Prospective Randomized Study for the Placement of Flexible Laryngeal Airway Mask with Two-Step of Jaw-Thrust Technique by Both Hands for Adults

To investigate the effect of two-step of jaw-thrust technique on the placement of flexible laryngeal mask with both hands. 157 patients scheduled for functional endoscopic sinus surgery were divided into two groups using a random number table method: control group (group C, n = 78) and test group (group T, n = 79). After induction of general anesthesia, the traditional method was applied to insert the flexible laryngeal airway mask in group C, and the two-step of jaw-thrust technique with both hands by the nurse was applied to help place the laryngeal mask in group T. The success rate, alignment status, oropharyngeal leak pressure (OLP) of the laryngeal mask, soft tissue injury of the oropharyngeal cavity and postoperative sore throat, and the incidence of adverse airway event were recorded in both groups. Results: The success rate of the first placement of flexible laryngeal masks in group C and group T were 73.8% and 97.5%, and the final success rates were 97.5% and 98.7%, respectively. Compared with group C, the success rate of first placement in group T was higher, and the difference was statistically significant (P < 0.01). There was no significant difference in the final success rate between the two groups (P = 0.56). The alignment score showed that the placement of group T was better than that of group C, and the difference was statistically significant (P < 0.01). The OLP of group C was 22.1 ± 2.6 cmH₂O, and the OLP of group T was 25.4 ± 3.8 cmH₂O. The OLP of group T was significantly higher than that of group C (P < 0.01). The incidence of mucosal injury and postoperative sore throat in group T were 2.5% and 5.0%, which were significantly lower than that of 23.0% and 16.7% in group C (both P < 0.01). There was no adverse airway event in each group. Conclusion: The two-step of jaw-thrust technique with both hands can improve the success rate of the first placement of the flexible laryngeal mask and the positioning of the laryngeal mask, increase the sealing pressure of the laryngeal mask, and reduce the incidence of oropharyngeal soft tissue injury and postoperative pharyngeal pain.