Abstract

Background: Successful airway management needs extensive knowledge and skills. In this study, we aimed to compare standard and reverse methods of laryngeal mask airway insertion in pediatric airway management.
Materials and methods: This clinical trial carried out on 68 children aged 6 months to 15 years with body weight of 5 to 7 kilograms undergoing elective inguinal hernia repair surgery and were divided into two groups of 34 people. Anesthesia induction was performed with midazolam 0.05 mg/kg, fentanyl 2 mcg/kg, lidocaine 1 mg/kg, and propofol 3 mg/kg and for airway management, laryngeal mask airway (LMA) was inserted. In the first group, laryngeal mask airway was inserted using standard method and in the second group, it was inserted using reverse method. Chest movements, time needed for mask insertion, airway pressure, and number of attempts to insert the LMA compared between the groups. 
Results: In this study, 68 patients (45 males and 23 females) with the mean age of 35.23 ± 31.83 months were studied. The mean duration of laryngeal mask insertion in all patients was 45.0 ± 11.60 seconds. We observed a significant difference in laryngeal mask insertion duration (P<0.001), the number of attempts for laryngeal mask insertion (P=0.016), and mucosal injury (P=0.039) between the two groups. 
Conclusion: Laryngeal mask insertion using reverse method is introduced as a facilitator in LMA insertion and a preferred selective method, due to lesser time needed for its insertion and fewer complications.