The Impact of the Triple Maneuver Technique on Laryngeal Mask Airway Efficiency: A Prospective Comparative Observational Cohort Study of Two Age Populations

Abstract

PURPOSE: This study aims to evaluate age-related differences in laryngeal mask airway (LMA) placement characteristics and outcomes by comparing elderly patients with younger adults. DESIGN: A prospective comparative observational cohort study was conducted in 120 participants who were undergoing elective ophthalmic surgery under general anesthesia. They were equally divided into two groups: younger (20 to 40 years) and older (65 to 85 years). METHODS: An LMA was placed using the Triple Maneuver Technique (TMT). The primary outcome was oropharyngeal leak pressure. Secondary outcomes were first-attempt success rate, LMA insertion time, and airway-related complications. FINDINGS: Oropharyngeal leak pressure was similar between groups (younger: 22.62 +/- 3.77 cm H(2)O; older: 21.95 +/- 3.40 cm H(2)O; P = .31). In older patients, the first-attempt success rate was significantly lower (76.7 vs 91.7; P = .024), and the LMA insertion time was longer (23.97 +/- 5.71 seconds vs 21.32 +/- 5.36 seconds; P = .01). The incidence of any complications was comparable between the two age groups (P > .05) for all comparisons CONCLUSIONS: TMT achieved comparable airway sealing quality across age cohorts, but older patients experienced lower first-attempt success rates and longer insertion times. These findings suggest that age-related anatomical changes affect TMT performance.