[A modified technique for insertion of the laryngeal mask airway in children]

We modified the technique for laryngeal mask airway (LMA) insertion in children. This modification involves inserting a two-thirds inflated LMA with its lumen facing laterally toward left and then rotating it 90 degrees clockwise as it passes downwards into position behind the larynx. Then the cuff is inflated fully. We conducted a survey on the use of LMA in ten consecutive children for minor superficial surgery. After slow induction, anesthesia was maintained with 3.0% of end-tidal sevoflurane concentration in 100% oxygen for 5 minutes before insertion of LMA. No muscle relaxant was used. Successful insertion was judged by the clinical integrity of the airway. The standard LMA insertion technique or another airway device was applied when three trials had failed. Traumatic insertion was observed by the attachment of blood clots to the surface of the removed LMA. A satisfactory airway was achieved in all of the children who participated in the survey. There were no significant differences in vital signs between pre- and post-insertion. Only one child was found to have attachment of blood clots on the surface of the removed LMA. We conclude that our technique would be one recommended method in pediatric practice.