ULTRASOUND CONFIRMATION OF LARYNGEAL MASK AIRWAY PLACEMENT CORRELATES WITH FIBEROPTIC LARYNGOSCOPE FINDINGS

Background: Correct placement of a laryngeal mask airway (LMA) requires confirmation to appreciate the adequacy of laryngeal seal and pulmonary ventilation. Objectives: The present study was designed to assess the feasibility of ultrasound use for confirmation of correct placement of LMA and its correlation with fiberoptic laryngoscopy as a confirmation tool for LMA position.Materials and Methods: 31 ASA I and II patients scheduled for same day surgery under general anesthesia underwent standard general anesthetic technique with AuraOnce™ or AuraFlex™ Disposable Laryngeal Mask Airways. The position of the LMA cuff was confirmed by transverse neck ultrasound (USG), and reconfirmed with intra-LMA fiberoptic laryngoscopy (FOL). Results: The ultrasound grade of LMA position strongly correlated positively with the fiberoptic grade of LMA position (r=0.92; p 0.0001). This correlation was obtained immediately after LMA placement, as well as just before LMA removal. The Bland-Altman scatter plot showed insignificant differences between the two grading systems with small and good limits of agreement (-0.63 to +0.57). Conclusion: Ultrasound examination can replace fiberoptic examination for confirmation of the correct placement of an LMA. Additionally, non-invasive ultrasound examination can further give insight into the cause of airway/ventilation events that may be interfering with the LMA placement and ventilation.