Objective To compare the application differences of disposable drainage double tube laryngeal mask airway(LMA)in gynecological general anesthesia surgery with patients weighing 50-70 kg,and to explore the selection criteria for LMA size suitable for gynecological general anesthesia patients.Methods A total of 300 patients who underwent general anesthesia gynecological surgery at the Shengjing Hospital of China Medical University from May to November 2023 were selected as the study subjects,weighing 50-70 kg.They were randomly divided into group A(No.3 laryngeal mask group)and group B(No.4 laryngeal mask group)according to a random number table method,with 150 patients in each group.Comparisons were made between two groups of patients in terms of the success rate of one tube placement,final tube placement failure rate,tube placement time,fiberoptic bronchoscopy positioning level,airway pressure,mean arterial pressure,heart rate,and postoperative pharyngeal complications(sore throat,hoarseness,dryness,bleeding,etc.)after laryngeal mask insertion.Results There was a statistically significant difference in the success rate and catheterization time between the two groups of patients(all P<0.05),while there was no statistically significant difference in the final catheterization failure rate,post catheterization airway pressure,mean arterial pressure(MAP),and heart rate(all P>0.05).The proportion of grade 1 fiberoptic bronchoscopy localization in group A(14%,21/150)was lower than that in group B(26.67%,40/150),while the proportion and average grade of grade 3 and 4 were higher than those in group B,and the differences were statistically significant(all P<0.05).The total number of postoperative pharyngeal complications in group A was less than that in group B,with statistically significant differences in sore throat and bleeding(P<0.05),but no statistically significant differences in dry hair,hoarseness,and other discomforts(all P>0.05).Conclusions In gynecological general anesthesia surgery for patients weighing 50-70 kg,using a No.3 laryngeal mask is easier to insert than a No.4 laryngeal mask,with better alignment of the laryngeal mask airway and glottis,and fewer postoperative pharyngeal complications.Therefore,selecting a No.3 laryngeal mask based on gender criteria is more suitable.