First Attempt Insertion Success of Novel Two Person Lateral Rotation Technique V.S Standard Brain Technique for LMA Insertion

N/ANot Yet RecruitingNCT07715708

Benha University70 enrolled

Overview

The goal of this clinical trial is to learn if two person lateral rotation technique of LMA insertion is more successful than the standard technique in achieving effective ventilation on the first introduction of the LMA .The main questions it aims to answer are: Does two person lateral rotation technique of LMA insertion lower the number of times needed to inesrt the LMA ? Researchers will compare two person lateral rotation technique of LMA insertion to standard technique to see if it is more successful Participants will be subjected to the two way of LMA insertion

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Enrollment

Conditions

LMA Ventilation

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adult patients aged 18-65 years * American Society of Anesthesiologists (ASA) physical status I-II * Scheduled for elective superficial surgical procedures under general anesthesia (e.g., limb orthopedic surgery, hernioplasty, soft tissue excision) * Anticipated surgical duration \< 90 minutes * Body mass index (BMI) 18.5-30 kg/m² Exclusion Criteria: * \- Anticipated difficult airway (Mallampati grade IV, thyromental distance \< 6 cm, limited neck extension) * History of gastroesophageal reflux disease or increased aspiration risk * Full stomach or emergency surgery - Intra-abdominal, laparoscopic, head and neck, or prone-position procedures - Known allergy to anesthetic agents * Pregnancy * Previous pharyngeal or laryngeal surgery - Inability to provide informed consent

Outcomes

Primary Outcomes

First-attempt insertion success rate, defined as successful placement achieving effective ventilation on the first introduction of the LMA into the oral cavity

Time frame: 1 minute after LMA insertion

Secondary Outcomes

Insertion time

Interval from picking up the LMA to confirmation of effective ventilation (square-wave capnogram, no audible leak at 20 cmH₂O, normal chest movement)

Time frame: 20-90 seconds from picking up the LMA to be inserted in the mouth

Number of attempts

Recorded up to a maximum of three; failure defined as inability to achieve effective ventilation after three attempts

Time frame: 2-3 minutes after induction of anesthesia

Need for manipulations

Chin lift, jaw thrust, head extension, neck flexion, or moderate advancement recorded as binary

Time frame: 1-2 minutes after induction of anesthesia

Oropharyngeal leak pressure (OLP)

Measured by closing the expiratory valve at a constant gas flow of 3 L/min with the upper pressure limit set to 30 cmH₂O; the pressure at which an audible leak is detected is recorded

Time frame: 1-2 minutes after insertion of LMA

Complications:

Blood staining on LMA (indicating mucosal trauma), sore throat (assessed postoperatively using a 4-point verbal rating scale), laryngospasm, hypoxia (SpO₂ \< 92%), and gastric insufflation (detected by epigastric auscultation)

Time frame: immediate after removal of LMA ,1,2,4,24 hours. post operative