Does Chin Lift Facilitate the Laryngeal Mask Airway Insertion in Neutral Position?

Wongpunkamol S.,M.D.,Boonsong P.,M.D.,Punjasawadwong Y.,M.D.,Loamuangthong C.,M.D.

Department of Anesthesiology, Faculty of Medicine, Chiangmai University, Chiangmai 50200

  The standard recommended insertion technique for the laryngeal mask airway (LMA) involves flexion of the neck and extension of the head. It is not known whether insertion of in neutral position is generally feasible with a view to its use in case of cervical spine instability. The ease of insertion of the LMA with the patient's head in neutral position aloe (group A,30 patients) and the facilitated technique,chin lift,(group B,30 patients) was compared in 60 healthy patients. The condition for LMA insertion was noted and successful insertion was assessed by the functioning of the airway. All complications and problems related to either technique were also recorded.
  In terms of the functioning of the airway, the successful insertion rate in neutral position alone was 60% (18/30) compared to the other group with chin lift 93% (28/30) (p = 0.006,Yates corrected chi-square's test).
  We concluded that the facilitation technique,chin lift,may have a role in the insertion of the LMA in the airway management in patients with known or suspected cervical spine instability.