Determining the Influence of Gastric Tube Placement in Upholding Correct Position of LMA Blockbuster throughout surgery: A Prospective Randomized Controlled Trial

Background and Aims: The LMA Blockbuster, with its unique 95° angulated airway tube, integrated bite block and gastric port, offers improved ease of insertion and higher sealing pressures. Despite correct placement, supraglottic airway devices may dislodge during surgery, especially when patient position changes or pneumoperitoneum is induced. This study assessed whether gastric tube insertion through the LMA Blockbuster’s gastric port maintains its position throughout surgery. Methods: In this prospective randomized controlled trial, 60 ASA I–II patients aged 20–70 years undergoing elective procedures under general anaesthesia were randomly assigned into two groups. In Group A (n=30), a lubricated gastric tube was inserted via the LMA Blockbuster’s gastric channel after placement; in Group B (n=30), no gastric tube was inserted. Placement stability was assessed by comparing fibreoptic bronchoscope (FOB) scores immediately after insertion and at the end of surgery. Secondary outcomes included gastric tube insertion success rate and post-insertion complications. Results: FOB score changed at the end of surgery when compared to baseline FOB score in 35% patients of Group B and 10% of Group A patients. Gastric tube insertion was successful in all Group A patients, with most insertions (90%) completed in a single attempt without resistance. Postoperative sore throat and vomiting incidence were similar between groups and mild in nature. Conclusion: Gastric tube placement via the LMA Blockbuster significantly reduces intraoperative displacement, as reflected in more stable FOB scores. This may be especially beneficial in surgeries with high risk of device displacement, such as laparoscopic procedures