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

Summary: Does age affect airway-mask placement? Among 120 surgery patients, older adults had slower, less successful first attempts, despite similar sealing. #Anesthesia #PatientSafety

Shetabi H ; Hashemi S T ; Naeli S
Source: Journal of Perianesthesia Nursing Published:2026

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 H₂O; older: 21.95 ± 3.40 cm H₂O; 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. © 2026 The American Society of PeriAnesthesia Nurses.