Simulation-Based Comparison of Standard Versus Rotational Laryngeal Mask Airway Insertion Techniques in Novice Anesthesiologists: A Randomized Controlled Crossover Trial.

Background: Anesthesia trainers frequently experienced desaturation, airway trauma, and failed intubation with novice hands-on training for facemask and endotracheal intubation. Laryngeal mask airway (LMA) adaptation in anesthesia practice has ensured trainers' ease in safely transforming sufficient airway management skills to develop competency among novice trainees. This study was designed to evaluate the manikin-based standard versus rotational LMA insertion techniques to analyze insertion ease and priority LMA insertion technique among novice anesthesia trainees. Methods: Our randomized controlled crossover trial has enrolled 13 novice anesthesia trainees from multicenter hospitals. The study comprised three phases. Initially, the study participants were inquired on a preformed questionnaire for supraglottic airway device knowledge, insertion techniques, and experiences. In the second phase, trainees have undergone educational tutorial, video presentation, and hands-on practice on a manikin for standard and rotational LMA insertion techniques. Following that, the participants were divided into two study groups to evaluate LMA insertion, 10 times each with standard and rotational in a crossover manner. The third phase of the study was also questionnaire-based; trainees were inquired about the preferred LMA insertion technique for beginners. Result: The trainee's prior knowledge of supraglottic airway devices and practical experience were equivocal. There were no insertion failure attempts with both standard and rotational LMA insertion techniques. The time duration for the first attempt with standard LMA insertion was significantly shorter (7.92 ± 2.43 s) compared to the time duration for the first attempt with rotational LMA insertion (11.80 ± 3.41 s) on manikin. The post-study analysis revealed trainees' preference for the standard LMA insertion technique. Conclusion: Our study concludes that the standard LMA insertion technique is relatively easy to learn and practice on manikin compared to the rotational technique. Besides this, the novice anesthesia trainees have preferred standard LMA insertion as a priority technique in their clinical practice. Trial Registration: ClinicalTrials.gov identifier: NCT05544838.