Glidescope~(TM) /gastric-tube guided technique: a back-up approach for ProSeal~(TM) LMA insertion

摘要

We read with interest the article by Garcia-Aguado et al. reporting the use of a suction catheter inside the drain tube as a guide for Proseal~(TM) laryngeal mask airway (PLMA) positioning. This technique may improve the success rate of PLMA insertion with less trauma to the mouth. For several years, we have been performing PLMA insertion with digital or introducer tool techniques. Our first-attempt success rate with a midline or lateral approach technique is > 80 %, similar to that reported by Cook et al? We agree with the authors that priming the PLMA with a 'guide, may provide an advantage in assuming better anatomic conformation of the mouth. For example, a narrow palate or an angle < 90?between the oral and the pharyngeal axis of the posterior tongue may result in folding over the distal cuff of the PLMA, preventing its correct positioning. We also observe that the PLMA first-attempt success rate is lower for less experienced users, who often find that this 'guide' directs the distal PLMA cuff towards the oesophagus.