Background
The Streamlined Liner of the Pharynx Airway (SLIPATM ) is widely used for pediatric anesthesia in China. However, based on the anatomical features of pediatric patients, novice residents are expected to have difficulties in inserting the device. The objective of this work was to improve the success rate, decrease the insertion time and reduce the complications of SLIPA use.
Methods
A total of 134 children were randomized into two groups. Anesthesia implementation was unified among all patients except for the way in which the SLIPA was inserted. One group underwent the conventional method of insertion (Group C), while the other group received a SLIPA that was bent the 120° at the ‘bridge’ point with an intubating stylet (Group M). We measured insertion success rate, insertion time, incidence of complications and hemodynamic responses to insertion. Insertion time was measured from the moment of opening the patient’s mouth until maintaining effective ventilation with two observed end-tidal carbon dioxide square waves. Hemodynamic indicators such as heart rate (HR), mean blood pressure (MBP) were recorded before induction, just before insertion, and 1 min and 5 min after insertion. The occurrence of complications was assessed in both groups, including the presence of blood on the SLIPA when removed, aspiration and regurgitation during surgery, sore throat, hoarseness and dysphagia at discharge from the post-anesthesia care unit (PACU) and 24 hours after surgery. 
Results
The insertion success rate was significantly higher in Group M than Group C. The insertion time for Group M was shorter than for Group C (Table 1). Trends in HR (F=0.260, P=0.794), MBP (F=0.167, P=0.683) did not significantly differ between the two groups over time. In terms of complications, we found no significant differences between groups (P>0.05, Table 2).
Conclusion
The 120° bend improved SLIPA insertion when performed by novice, as reflected by higher insertion success rates and shorter insertion times, with no differences in hemodynamic response to insertion or the incidence rates of complications between the two groups.

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