Disposable laryngeal tube suction—A randomized comparison of two insertion techniques performed by novice users in anaesthetised patients

Summary Objective Laryngeal tubes are supraglottic airway devices that can be used in alternative to a tracheal tube to provide ventilation during cardiopulmonary resuscitation. The product line has recently been expanded by the disposable laryngeal tube suction (LTS-D). We tested the hypothesis that, with a modified insertion technique (MIT), the rate of correct placement attempts within 45 s could be significantly increased compared to the standard insertion technique (SIT) recommended by the manufacturer. Methods Fifty-four adult patients undergoing trauma surgery under general anaesthesia had an LTS-D inserted by first-time users, randomly assigned to the SIT or a MIT. A brief manikin-based demonstration of the device and the assigned technique was given before insertion. In the MIT the tip of the LTS-D was rotated by 180° prior to insertion. Forced chin lift to create sufficient retropharyngeal space was performed with the other hand. Introduced to one-third of its length, the LTS-D was again rotated by 180° and pushed down the pharynx. The rate of successful tube placements within 45 s was the main outcome variable. Results Insertion took 73 ± 41 s (SIT) and 40 ± 8 s (MIT, P < 0.01). Insertion within 45 s was possible in n = 7/27 patients (26%, SIT) and in n = 20/27 patients (74%, MIT, P < 0.01). In one patient of the MIT group, placement failed. Non-anaesthesia personnel, such as nurses and emergency medical technicians ( n = 27), performed comparably to board-certified anaesthesiologists or those in training ( n = 27). Conclusion Applying a MIT significantly reduced the time for successful insertion of an LTS-D by first-time users. Insertion within 45 s was significantly more frequent with this technique. Further studies need to be conducted to determine if the LTS-D can be recommended as a first-line airway during cardiopulmonary resuscitation.