A prospective fiberoptic evaluation of the Supreme™ Laryngeal Mask Airway

Abstract

Background: Since March 2007, a new disposable Laryngeal Mask Airway has become available. The LMA SupremeTM (LMA-S) aims to combine the LMA Fastrach'sTM feature of easy insertion with the gastric access and high oropharyngeal leak pressures (OLP) of the LMA ProSealTM (PLMA). Methods:We performed an evaluative study with LMA-S size 4 on 100 female patients to measure the ease of insertion, to determine the laryngeal fit by fiberoptic classification, to evaluate the OLP, and to report adverse events. Results: Insertion of the LMA-S was possible in 94 (94.0%) patients during the first attempt and in the remaining five (5.0%) during the second attempt. In one small patient, LMA-S could not be inserted due to limited pharyngeal space. This patient was excluded from further analysis. Insertion of a gastric tube was possible in all patients at the first attempt. Mean time for LMA-S insertion was 12.8 (8-30 ±4.7) seconds. Laryngeal fit evaluated by fiberscopic view was rated as optimal in all patients, both immediately after insertion of the LMA-S and at the end of surgery. After equalization to room pressure, mean cuff volume needed to achieve 60 cmH2O cuff pressure was 18.4 (8-31 ±3.8) mL. Mean OLP at the level of 60 cmH2O cuff pressure was 28.1 (21-35 ±3.8) cmH2O. Eight (8.1%) patients complained of a mild sore throat. No patient reported dysphagia or dysphonia. Conclusions: Clinical evaluation of LMA-S showed easy insertion, optimal laryngeal fit, and low airway morbidity. OLP results were comparable to earlier data from PLMA.