Laryngeal Mask Airway Supreme Research Articles

LMA Protector Cuff Pilot vs LMA Supreme Among Anaesthetised, Non-Paralysed Patients

LMA Protector Cuff Pilot vs LMA Supreme Among Anaesthetised, Non-Paralysed Patients

Comparison of the effects of supreme laryngeal mask airway and endotracheal tube on airway reflexes in patients who underwent nasal surgery: A randomized, controlled clinical triall

Aim: The primary purpose of this study was to compare the effects of supreme laryngeal mask airway (SLMA) and endotracheal tube (ETT) on (laryngospasm, bronchospasm, cough, desaturation) airway reflexes in patients who undergo nasal surgery. The secondary purpose was to evaluate the hemodynamic responses in this respect.Material and Methods: The study was conducted as a prospective, randomized, single blind and controlled clinical trial in 92 patients between the ages of 18 and 65 for whom elective nasal surgery was planned, who volunteered for the study and who were American Society of Anaesthesiologists (ASA) I-II group. The patients were divided randomly into two groups as the supreme laryngeal mask (SLMA Group, n = 46), and the endotracheal tube (ETT Group, n = 46). The laryngospasm, bronchospasm, cough, desaturation (SpO2 ≤90) and hemodynamic parameters were evaluated after the extubation (T1) 5th and (T2) 60th minutes.Results: The demographic data were similar in both groups. In the SLMA Group, laryngospasm was detected at T1: (5th minute after the extubation) in 2 (4.3%) patients, Bronchospasm was detected at T1 (2.2%) in 1 patient, cough was detected at T1 in 4 (8.7%) patients, desaturation was detected at 3 (6.5%) patients. In the ETT Group, laryngospasm was detected at T1 (13%) in 6 patients (13%), bronchospasm was detected at T1 in 2 patients (4.3%), cough was detected at T1 (10.9%) in 5 patients, desaturation was detected in 5 patients (10.9%). There were no statistically significant differences between the groups in terms of the perioperative respiratory complications. Conclusion: It was determined in our study that the incidence of the respiratory adverse events (laryngospasm, bronchospasm, and cough) in the patients applied SLMA was less than ETT in nasal surgery patients undergoing general anesthesia.

Comparative performance of I-gel and laryngeal mask airway supreme: A randomised, controlled study

Patients and Methods: In a randomised, controlled study, we compared the performance of i-gel against the laryngeal mask airway (LMA) Supreme in 60 anaesthetised and paralysed patients for non-laparoscopic surgical procedures. Results: The primary outcome measure, the oropharyngeal leak pressure (OLP), was significantly higher for i-gel as compared to LMA Supreme (mean [standard deviation] 26.23 [4.09] vs 21.73 [3.19] cm H2O, respectively; P

Comparison of Laryngeal Mask Airway Proseal and Supreme in Patients Posted for Elective Surgeries Under General Anaesthesia: A Randomised Clinical Trial

Comparison of Laryngeal Mask Airway Proseal and Supreme in Patients Posted for Elective Surgeries Under General Anaesthesia: A Randomised Clinical Trial

An Observational Study to Compare Ambu Auragain and Supreme Laryngeal Mask Airway for Controlled Ventillation Under Anaesthesia

An Observational Study to Compare Ambu Auragain and Supreme Laryngeal Mask Airway for Controlled Ventillation Under Anaesthesia

Comparative Study of LMA Supreme versus I-gel in Patients Undergoing Laparoscopic Surgeries with Positive Pressure Ventilation

Comparative Study of LMA Supreme versus I-gel in Patients Undergoing Laparoscopic Surgeries with Positive Pressure Ventilation

Use of laryngeal mask after repeated endotracheal intubation failure in a patient with tracheobronchopathia osteochondroplastica: case report

We report a case of difficult endotracheal intubation in a patient with tracheobronchopathia osteochondroplastica. A 65-year-old man was scheduled to undergo ulnar nerve decompression and ganglion excisional biopsy under general anesthesia. During induction of general anesthesia, an endotracheal tube could not be advanced through the vocal cords due to resistance. A large number of nodules were identified below the vocal cords using a Glidescope® video-laryngoscopy, and fiberoptic bronchoscopy revealed irregular nodules on the surface of the entire trachea and the main bronchus below the vocal cords. Use of a small endotracheal tube was attempted and failed. a laryngeal mask airway (LMA Supreme ™) rather than further intubation was successfully used to maintain the airway.

Does a supreme laryngeal mask airway (SLMA) selected on the basis of a patient’s weight provide an optimal fit in Indian population?

Background: The Supreme laryngeal mask (SLMA), is a second generation Laryngeal mask airway (LMA) introduced in 2007. Designed in the West on Caucasian population, most studies have been conducted on the same population. There is no study to evaluate the fit of a SLMA chosen on the weight based criteria in Indian population. Aim: The aim or objective of the study was to identify whether SLMA selected on the basis of weight criteria provides an appropriate fit in Indian population?

Intraoperative Breakage of LMA Supreme in Anticipated Difficult Airway

Background: The laryngeal mask airway (LMA) Supreme is a single-use, second-generation supra-glottic airway device that gained popularity because of its ease of insertion and higher sealing pressure. We report a case of intra-operative LMA supreme breakage in a patient with anticipated difficult airway. Case Report: A 41 year-old female patient with anticipated difficult airway was posted for modified radical mastectomy under general anesthesia utilizing LMA Supreme. After one hour of uneventful surgery significant air leak was noticed. After excluding all possible causes of air leak, while repositioning the LMA, we noticed a break in LMA. The airway was successfully rescued with an endotracheal tube (ETT) rail-roaded over a bougie inserted through the broken end of the LMA. The breakage could be attributed to inadvertently exerted pressure and remained unnoticed because the LMA was covered by surgical drapes. Conclusion: Continuous vigilance and preparedness to handle difficult airways throughout the procedure are essential to manage such cases.

General Anesthesia with the Use of SUPREME Laryngeal Mask Airway for Emergency Cesarean delivery: A Retrospective Analysis of 1039 Parturients

In comparison to elective cesarean delivery, emergency cesarean delivery under endotracheal intubation is associated with higher risk of life-threatening airway problems. In this retrospective study, we evaluate the efficacy and feasibility of using SUPREME laryngeal mask airway (SLMA) in emergency cesarean delivery under general anesthesia (GA). The study included a total of 1039 paturients undergoing emergency cesarean delivery under GA with SLMA from January 2015 to December 2015 at Quanzhou Children’s and Women’s Hospital. Outcome measures included incidence of the adverse events related to using SLMA, maternal mortality, and neonatal outcomes. Briefly, no aspiration or regurgitation was noticed; the first attempt was successful in all but 2 subjects, both because of incorrect location, one was detected by decreasing oxygenation and the other by high airway pressure, the second attempt was successful in both cases. No subject was switched to endotracheal intubation. No laryngospasm or bronchospasm was detected. No maternal death occurred. There were 1139 neonates (including 944 single birth, 92 twins, 3 triplets) in this study, 5-min Apgar score was 7–10 in 1092 (96.72%) neonates. Thirty-seven (3.28%) neonates received endotracheal intubation. In conclusion, this retrospective study showed that the SLMA was used successfully in 1039 patients undergoing emergent cesarean delivery without any major complications. Vigilant attention by attending anesthesiologists is warranted.

A Comparative Study of Supreme LMA Vs I-gel: Two Supraglottic Airway Devices in Short Surgical Procedures

Background and Aims: The objective of this prospective, randomized trial was to compare I-Gel with Supreme LMA in anaesthetized spontaneously breathing patients for short surgical procedures. Material and Methods: Sixty patients of ASAI -ASAII of either gender between 18-60 years undergoing short surgical procedures were randomly assigned to I-gel (Group I) or LMA-Supreme (Group S). After induction with propofol the supraglottic airway device was inserted. We compared the ease and time required for insertion, airway sealing pressure and adverse events related to airway. Results: There were no significant differences in demographic and haemodynamic data. I-gel insertion was easier than LMA Supreme but statistically not significant (p > 0.05) (Chi square test). Numbers of attempts for successful insertions were comparable and in majority device was inserted in first attempt. Although the airway sealing pressure was significantly higher with Group S (25.73+2.21 cm of H2O), the airway sealing pressure of Group I (20.0+2.94 cm of H2O) was very well within normal limit (Student's t test). There was no evidence of airway trauma, regurgitation and aspiration. Conclusion: I-Gel with acceptable limits airway sealing pressure, easier to insert, less traumatic with lower incidence of sore throat. Hence I-Gel can be a good alternative to LMA-Supreme.

Randomized comparison of the Baska FESS mask and the LMA Supreme in different head and neck positions

ABSTRACTBackground: The Baska functional endoscopic sinus surgery (FESS) mask is a new supraglottic airway designed for head and neck procedures. This prospective, randomized controlled trial compared the oropharyngeal leak pressure (OLP) of the Baska FESS mask with the laryngeal mask airway (LMA) Supreme in different head and neck positions.Methods: One hundred patients undergoing elective surgery were recruited. OLP was compared in supine position, 45° lateral rotation, 45° neck extension, and 30° neck flexion. Glottic view, insertion time, ease of insertion, number of attempts, ease and time of insertion of gastric tube, and complications were also compared.Results: The OLP of the Baska FESS was higher than the LMA Supreme in all head and neck positions studied (p < 0.001). Glottic views were better in the Baska FESS in supine and lateral rotation. LMA Supreme was easier (p = 0.046) and faster (p < 0.001) to insert. First attempt insertion success rates were 91.8% for Baska FESS and 98% for LMA Supreme. Gastric drain was easier and faster to insert (p < 0.001) in the LMA Supreme.Conclusions: The Baska FESS provides a superior airway seal with higher mean OLP than the LMA Supreme in all head and neck positions studied. However, LMA Supreme was superior in terms of ease and speed of insertion.

To compare Proseal laryngeal mask airway &amp;amp; supreme laryngeal mask airway as ventilatory devices

Background: The present study was conducted to compare Proseal laryngeal mask airway (PLMA) and Supreme laryngeal mask airway (SLMA) as ventilatory devices during general anaesthesia. Materials & Methods: The present study was conducted on 30 patients of both genders undergoing elective surgery. Patients were divided into 2 groups of 15 each. Group I patients were given Proseal laryngeal mask airway and group II were given supreme laryngeal mask airway. In both groups, insertion times, number of insertion attempts, Haemodynamic response to insertion, ease of insertion of airway device and gastric tube, oropharyngeal leak pressure (OLP) and pharyngolaryngeal morbidity were assessed. Results: In group I (cm H2O), OLP1 was 34.2 and in group II was 28.4, OLP2 in group I was 34.2 and in group II was 28.5, OLP3 in group I was 34.3 and in group II was 28.6. The difference was significant (P

A Comparative Study of Supreme LMA Vs I-gel : Two Supraglottic Airway Devices in Short Surgical Procedures"

Background and Aims: The objective of this prospective, randomized trial was to compare I-Gel with Supreme LMA in anaesthetized spontaneously breathing patients for short surgical procedures. Material and Methods: Sixty patients of ASAI -ASAII of either gender between 18-60 years undergoing short surgical procedures were randomly assigned to I-gel (Group I) or LMA-Supreme (Group S). After induction with propofol the supraglottic airway device was inserted. We compared the ease and time required for insertion, airway sealing pressure and adverse events related to airway. Results: There were no significant differences in demographic and haemodynamic data. I-gel insertion was easier than LMA Supreme but statistically not significant (p > 0.05) (Chi square test). Numbers of attempts for successful insertions were comparable and in majority device was inserted in first attempt. Although the airway sealing pressure was significantly higher with Group S (25.73+2.21 cm of H 2 O), the airway sealing pressure of Group I (20.0+2.94 cm of H 2 O) was very well within normal limit (Student’s t test). There was no evidence of airway trauma, regurgitation and aspiration. Conclusion: I-Gel with acceptable limits airway sealing pressure, easier to insert, less traumatic with lower incidence of sore throat. Hence I-Gel can be a good alternative to LMA-Supreme.

Comparison of Different Cuff Pressure Use with the Supreme Laryngeal Mask Airway on Haemodynamic Response, Seal Pressure and Postoperative Adverse Events: A Prospective Randomized Study.

The Supreme™ laryngeal mask airway (SLMA) is a supra glottic airway (SGA) device that is used as an alternative to endotracheal tubes. In the present study, we aimed to compare the use of the SLMA with normal cuff pressure and low cuff pressure, primarily for haemodynamic response. In the present study, 120 patients diagnosed with hypertension and scheduled for varicose vein or inguinal hernia operation were enrolled and 99 patients finished. Using randomization, patients were divided into two groups according to cuff pressure as a low-pressure group (Group L, 45 cm H2O) and a normal-pressure group (Group N, 60 cm H2O). Demographics, Mallampati score and the type and duration of surgery, heart rate (HR), mean arterial pressure (MAP), percentage of tidal volume leakage, Ppeak, Pmean, etCO2, seal pressure, fibreoptic scores and postoperative adverse effects of all patients were recorded. MAP and HR values immediately and 2 minutes after SLMA insertion were significantly lower in Group L (p<0.001). In Group L and Group N, the seal pressures were 24.1±3.1 cm H2O and 26.2±3.9 cm H2O, respectively (p=0.003). Also, blood staining and sore throat occurred less frequently in Group L (p<0.05). The fibreoptic average score, insertion features and ventilation parameters were similar between the groups (p>0.05). SLMA use with a cuff pressure of 45 cm H2O significantly decreases haemodynamic response and post-operative side effects compared with a normal cuff pressure. Therefore, except for some specific surgeries that require higher seal pressures, we recommend the use of the SLMA with cuff pressures as low as 45 cm H2O.

Predictive risk factors of failed laryngeal mask airway insertion at first attempt.

ObjectivesA failed first attempt at laryngeal mask airway (LMA) insertion could increase the risk of laryngospasm, hypoxemia, and postoperative sore throat. This study was performed to investigate the risk factors for failed first-attempt LMA placement.MethodsIn total, 461 patients who underwent general anesthesia with a Supreme LMA (Teleflex Medical, Shanghai, China) and who had an American Society of Anesthesiologists (ASA) physical status of I to III were prospectively enrolled. The LMA was inserted after anesthetic induction. We recorded the insertion conditions and each patient’s age, ASA status, body weight, body mass index (BMI), duration of anesthesia, size of LMA, and cuff pressure; the years of work experience of the anesthesiologists; and the use or nonuse of lidocaine gel as a lubricant.ResultsSuccessful first-attempt placement of the Supreme LMA was achieved in 438 (95.10%) patients, while first-attempt placement failed in 23 (4.99%). Significant risk factors for failure of first-attempt LMA insertion included high age, high body weight, BMI of <20 kg/m2, and insertion without using lidocaine gel.ConclusionsA patient age of >61 years, high body weight, BMI of <20 kg/m2, and insertion without lidocaine gel could significantly increase the risk of failed first-attempt Supreme LMA insertion.

A comparison between the Supreme laryngeal mask airway and the laryngeal tube suction during spontaneous ventilation: A randomized prospective study.

Background and Aims:The Supreme laryngeal mask airway (SLMA) and the laryngeal tube suction-disposable (LTS-D), both second-generation supraglottic airway devices, have a record of efficiency when used for airway management in mechanically ventilated patients, during general anesthesia. There is no published data comparing these two devices in patients breathing spontaneously during general anesthesia.Material and Methods:Eighty patients with normal airways undergoing elective general anesthesia with spontaneous ventilation were randomized to airway management with a SLMA or LTS-D. Efficacy and adequacy of oxygenation and ventilation were compared.Results:No cases of desaturation of oxygen saturation (SpO2) values of less than 95% occurred with either device. The mean difference for SpO2 between the two devices (0.7%) has no clinical significance. Slight hypercapnia was noted with both devices to acceptable values during spontaneous ventilation.Conclusions:Both SLMA and LTS-D are suitable and effective for airway management in patients breathing spontaneously during general anesthesia for minor surgery of short duration.

A comparative evaluation of ProSeal laryngeal mask airway, I-gel and Supreme laryngeal mask airway in adult patients undergoing elective surgery: A randomised trial.

Background and Aims:Second-generation supraglottic airway devices are widely used in current anaesthesia practice. This randomised study was undertaken to evaluate and compare laryngeal mask airway: ProSeal laryngeal mask airway (PLMA), Supreme laryngeal mask airway (SLMA) and I-gel.Methods:Eighty-four adult patients undergoing elective surgery were randomly allocated to three groups: group P (PLMA), group I (I-gel) and group S (SLMA) of 28 patients each. Insertion times, number of insertion attempts, haemodynamic response to insertion, ease of insertion of airway device and gastric tube, oropharyngeal leak pressure (OLP) and pharyngolaryngeal morbidity were assessed. The primary outcome measure was the OLP after successful device insertion. Statistical analysis was performed using Statistical Package for the Social Sciences version 18.0 software using Chi-squared/Fisher's exact test (categorical data) and analysis of variance (continuous data) tests. P < 0.05 was considered statistically significant.Results:The demographic profile of patients was comparable. OLP measured after insertion, 30 minutes later and at the end of surgery differed significantly between the three groups (P < 0.001). The mean OLP was 32.64 ± 4.14 cm·H2O in group P and 29.79 ± 3.70 cm·H2O in group S. In group I, the mean OLP after insertion was 26.71 ± 3.45 cm H2O, which increased to 27.36 ± 3.22 cm H2O at 30 minutes and to 27.50 ± 3.24 cm H2O towards the end of surgery. However, these increases were not statistically significant (P = 0.641). Device insertion time was longest for group P (P = 0.001) and gastric tube insertion time was longest for group I (P = 0.001). Haemodynamic response to insertion and pharyngolaryngeal morbidity were similar with all three devices.Conclusion:PLMA provides better sealing pressure but takes longer to insert. I-gel and SLMA have similar sealing pressures. I-gel insertion time is quicker.

Comparitive Study of I-Gel Vs Supreme LMA in Anaesthetised Patients on Spontaneous Ventilation

Comparitive Study of I-Gel Vs Supreme LMA in Anaesthetised Patients on Spontaneous Ventilation

Pediatric supraglottic airway devices in clinical practice: A prospective observational study

BackgroundSupraglottic airway devices (SGA) are commonly used in pediatric anesthesia and serve as primary or back-up devices for difficult airway management. Most SGA are marketed without proper clinical evaluation. The purpose of this study was to evaluate the performance of the pediatric LMA Supreme™, Air-Q® and Ambu® Aura-i™.MethodsThis prospective observational study was performed at Bern University Hospital, Switzerland. With ethics committee approval and a waiver for written informed consent 240 children undergoing elective surgery with an ASA class I-III and a weight of 5-30 kg were included. Three different pediatric supraglottic airway devices were assessed: The LMA Supreme™, Air-Q® and Ambu® Aura-i™. Primary outcome parameter was airway leak pressure. Secondary outcome parameters included first attempt and overall success rate, insertion time, fiberoptic view through the SGA, and adverse events. The primary hypothesis was that the mean airway leak pressure of each tested SGA was 20 cmH2O ± 10%.ResultsNone of the SGA showed a mean airway leak pressure of 20 cmH2O ± 10%, but mean airway leak pressures differed significantly between devices [LMA Supreme™ 18.0 (3.4) cmH2O, Air-Q® 15.9 (3.2) cmH2O, Ambu® Aura-i™ 17.3 (3.7) cmH2O, p < 0.001]. First attempt success rates (LMA Supreme™ 100%, Air-Q® 90%, Ambu® Aura-i™ 91%, p = 0.02) and overall success rates (LMA Supreme™ 100%, Air-Q® 91%, Ambu® Aura-i™ 95%, p = 0.02) also differed significantly. Insertion times ranged from 20 (7) seconds (Air-Q®) to 24 (6) seconds (LMA Supreme™, <p = 0.005). Insertion was rated easiest with the LMA Supreme™ (very easy in 97% vs. Air-Q® 70%, Ambu® Aura-i™ 72%, p < 0.001). Fiberoptic view was similar between the SGA. Adverse events were rare.ConclusionsAirway leak pressures ranged from 16 to 18 cmH2O, enabling positive pressure ventilation with all successful SGA. The highest success rates were achieved by the LMA Supreme™, which was also rated easiest to insert.Trials RegistrationClinicalTrials.gov, identifier NCT01625858. Registered 31 May 2012.