Wooden Disposable Tongue Depressor: Can Facilitate Appropriate Reinforced Laryngeal Mask Insertion? A Randomized Controlled Trial

Background: The reinforced laryngeal mask airway (RLMA) is difficult to insert due to the flexibility of its inner armored shaft. Many authors agreed that the available techniques have some disadvantages. They use materials that are reusable and require resterilization but may not guarantee infection control particularly during pandemics. The standard method can cause contamination and prone the operator to unanticipated trauma to their finger during placement. So this study aimed to evaluate the usefulness of disposable tongue depressors to aid insertion of the reinforced laryngeal mask airway. Methods: A randomized controlled trial included one hundred ninety-four adult patients of either gender American Society of Anesthesiologists (ASA) I and II attended for elective day case surgery under general anesthesia. Patients were randomly categorized into two groups; each group consisted of ninety-seven. In the first group, insertion of the reinforced laryngeal mask airway was done using the standard technique of digital manipulation whereas the second one is the study group where disposable wooden tongue depressor guided insertion was used. The data were analyzed using SPSS version 23. Data were presented as frequencies or means and standard deviations. Chi-Square, Fisher Exact, and t-test were used. P value < 0.05 was considered significant. Results: No significant difference in basic patients' demographic, anthropometric, and clinical characteristics were noticed between the two groups. The insertion time as well as the total time for RLMA placement, was significantly shorter in the new method group. Trauma was significantly less than 2.1% in the new method group compared to the standard group 10.3%, p=0.003). Conclusion: The disposable wood tongue depressor insertion technique helps facilitate the correct placement of the reinforced laryngeal mask airway.