Effect of Head Elevation on LMA Insertion

Study Overview
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Brief Summary
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The purpose of this study is to compare the first attempt success rate of laryngeal mask airway insertion according to the degree of head elevation.

Detailed Description
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The purpose of this study is to compare the first attempt success rate of laryngeal mask airway insertion between 7 cm head elevation and 14 cm head elevation in patients who undergoing transurethral bladder tumor resection.

Official Title
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Effect of Head Elevation on LMA Supreme Insertion in Patients Undergoing Transurethral Resection of Bladder Tumor: a Randomized Controlled Trial

Conditions
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Laryngeal Masks, Urinary Bladder Neoplasms

Intervention / Treatment
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* Procedure: Laryngeal mask airway insertion


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients who are scheduled transurethral bladder tumor resection under general anesthesia 20-79 years of age American Society of Anesthesiologists physical status ≤3 Patients who are voluntarily agreed to this clinical study Exclusion Criteria: History of difficult airway Expected difficult airway by physical examination Unstable teeth or teeth loss Obesity (body mass index ≥ 30) Recent history of upper respiratory infection Patients who are not fasted or who are at risk of aspiration

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 79 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Evaluation with 14 cm high pillow<br>When inserting laryngeal mask airway, head elevation is performed using a 14 cm high pillow. | Procedure: Laryngeal mask airway insertion<br>* Laryngeal mask airway insertion in patients who undergoing transurethral bladder tumor resection<br>|
| Active Comparator: Evaluation with 7 cm high pillow<br>When inserting laryngeal mask airway, head elevation is performed using a 7 cm high pillow. | Procedure: Laryngeal mask airway insertion<br>* Laryngeal mask airway insertion in patients who undergoing transurethral bladder tumor resection<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| First attempt success rate | The rate of success at the first attempt of laryngeal mask airway insertion | Immediately after mask airway insertion | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The percentage of glottic opening score | The percentage of glottic opening by fiberoptic view | Immediately after mask airway insertion | 
| Laryngeal mask airway insertion-related patient satisfaction | A seven-point Likert scale | At postoperative 6 hours | 
| Second attempt success rate | The rate of success at the second attempt of laryngeal mask airway insertion | Immediately after mask airway insertion | 
| Third attempt success rate | The rate of success at the third attempt of laryngeal mask airway insertion | Immediately after mask airway insertion | 
| Oropharyngeal leak pressure | Oropharyngeal leak pressure is measured as follows: After setting the expiratory valve to 30 cmH2O at a fixed gas flow rate of 3 L/min, the maximum inflation pressure is measured when a noise of gas leakage is heard in the oropharynx via a stethoscope. | Immediately after mask airway insertion | 
| Reposition rate | The rate of reposition after laryngeal mask airway insertion when ventilation is ineffective or air leaks | After mask airway insertion (up to end of surgery) | 
| Complications associated with laryngeal mask airway insertion | Complications related with laryngeal mask airway insertion such as cough, vomit, aspiration, regurgitation, bleeding, laryngospasm, and bronchospasm | Up to postoperative 3 days |