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The LMA Supreme™ – a pilot study

Authors

van Zundert A.

Publication

Anaesthesia 2008; 63 (2): 209–210

Summary

  • A study to determine the performance of the LMA Supreme™ in anaesthetised patients
  • The insertion of the LMA Supreme™ was considered ‘easy’ on the first attempt in all patients
  • The LMA Supreme™ appears to combine many of the best features of other supraglottic airway devices, including the LMA ProSeal™, LMA Fastrach™ and LMA Unique™ devices, within a single device

Objectives:

  • To determine the performance of the LMA Supreme™ in anaesthetised patients

Method:

  • This was a prospective pilot study undertaken in American Society of Anesthesiologists class 1 or 2 patients aged 18-60 years
  • Outcomes of interest were
    • Ease of insertion (i.e. number of insertion attempts and time taken to secure an effective airway)
    • Oropharyngeal leak pressure
    • Anatomical position (determined by fibreoptic inspection via the distal end of the airway tube)
    • Intra-cuff pressure change
    • Airway trauma and morbidity

Results:

  • Overall, 22 patients were included in the study
    • The mean age and body weight of included patients (18 of whom were female) was 38 years and 73 kg, respectively
  • The LMA Supreme™ was successfully inserted in all of the study participants, with insertion being considered ‘easy’ on the first attempt in all instances (Figure 1)
  • The mean time to secure an effective airway (from picking up the device to the first breath) was 28 seconds
  • The mean oropharyngeal leak pressure was 37 cm H2O; this was likely the result of an increase in intra-cuff pressure (mean 24 cm H2O)
    • Oropharyngeal leak pressure increased during anaesthesia (Figure 2)
Figure 1. Ease of insertion of the LMA Supreme™ on the first attempt (n=22)

Figure 2. Oropharyngeal leak pressure during the course of anaesthesia (data are shown as mean ± standard deviation)

  • The vocal cords were visible from the distal end of the airway tube in all patients
  • Insertion of the gastric tube was successful on the first attempt in all patients
  • No blood was observed on the LMA Supreme™ following its removal and no lip, tongue or mouth trauma was evident
  • At 2 hours post-surgery there were no reports of a sore throat, dysphagia or dysphonia

Conclusions:

  • The LMA Supreme™ appears to combine many of the best features of other supraglottic airway devices, including the LMA ProSeal™, LMA Fastrach™ and LMA Unique™ devices

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