Jaw thrust as a predictor of insertion conditions for the proseal laryngeal mask airway

Townsend, Russell, Brimacombe, Joseph R., Keller, C., Wenzel, Volker, and Herff, Holger (2009) Jaw thrust as a predictor of insertion conditions for the proseal laryngeal mask airway. Middle East Journal of Anesthesiology, 20 (1). pp. 59-62.

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We test the hypothesis that the response to jaw thrust is an effective predictor of insertion conditions for the ProSeal laryngeal mask airway (ProSeal LMA). One hundred and sixty patients (ASA grade 1-3, aged >18 yr) were studied. Five anesthetists blinded to the response to jaw thrust participated in the study, each performed >30 insertions. Induction of anesthesia was with propofol titrated to loss of lash reflex and apnea. A standard amount of jaw thrust was applied and any motor response noted by three observers. The ProSeal LMA was inserted using the standard digital technique. Insertion conditions were considered optimal if there was no motor or upper airway reflex response to insertion. There was no response to jaw thrust in 86% (137/160) of patients and insertion was optimal in 76% (121/160) of patients. A response to jaw thrust predicted suboptimal insertion conditions in 74% (17/23) and a lack of response predicted optimal insertion conditions in 84% (115/137). The accuracy, sensitivity and specificity were 0.82, 0.95 and 0.44, respectively. We conclude that jaw thrust is a reliable predictor of insertion conditions for the ProSeal LMA with the digital insertion technique after induction of anesthesia with propofol. We suggest that clinicians learn how to apply the correct amount of jaw thrust and perform this test routinely.

Item ID: 5481
Item Type: Article (Research - C1)
ISSN: 0544-0440
Keywords: ProSeal laryngeal mask airway; clinical test; jaw thrust; complications
Date Deposited: 26 Nov 2009 22:28
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110301 Anaesthesiology @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920118 Surgical Methods and Procedures @ 100%
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