A Comparison of Supraglottic Airway Devices

As a result of studies regarding the provision of an airway which is less invasive than intubation but safer than mask to maintain patency of airway after anesthesia induction in brief surgical interventions, supraglottic airway devices have been introduced into practice. They are inserted to glottic entry via the oral route and can be used in emergent conditions where tracheal intubation and mask anesthesia are challenging.

Classic LMA was first introduced by Archie Brain, MD in 1988, and consists of a mask with a surrounding inflatable bag compatible to the shape of the hypopharynx and a tube that has a 30° angle with a mask.

Fastrach LMA ( LMA Fastrach: LMA North America. Inc. San Diego. CA) was first introduced in 1997 and has similar features to the LMA Classic, but it is designed to provide upper airway during intubation via blind intubation or fiberoptic assistance. It has a rigid handle that allows one-handed insertion, removal or adjustment.

Supreme LMA, first introduced in April, 2007, is a novel, sterile, single use, new generation supraglottic airway device which provides more rapid and higher volume gas passage through airway and can be inserted in a rapid and safe manner because of the advanced cuff and airway tube. The integrated gastric canal facilitates gastric aspiration.

Supraglottic airway devices seem to have advantages over each other in different aspects due to their distinct features. In literature, there are studies comparing various LMA types for different features. However, to best of our knowledge, there is no study comparing these 3 types of LMA regarding these parameter. This is the main point of difference of our study.

Inclusion criteria

• normotensive patients with mouth aperture > 3 cm,
• thyromental distance > 6 cm,
• sternomental distance > 12.5 cm,
• body mass index < 35 kg m-2 were included in the study.

Exclusion criteria

• patients with ASA III-IV,
• those with a history of gastroesophageal reflux,
• pregnancy,
• cardiovascular and central nerve system disease,
• those with difficulty in cooperation,
• those undergoing intracranial, intraabdominal and Ear-nose-throat surgeries were excluded from study.

None of the methods changed after commencement of the study.