Author's reply to Thomas et al.

Editor—We are pleased that Thomas and colleagues¹ agree with many of the conclusions in our Editorial and audit²³ of suboptimal laryngeal mask airway (LMA) placement. We agree with several points they make in their letter. If initial attempts fail, Magill forceps can be used to guide the flexible LMA beyond the epiglottis, or the cuff can be deflated even further, or more jaw thrust can be applied. All of these are included in our proposals. It is self-evident that there should be adequate levels of anaesthesia, but it would have been unnecessary to repeat such a fundamental point, as that necessity has been emphasized elsewhere.⁴

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