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LMA Supreme™ insertion by novices in manikins and patients

Authors

Howes B.W. et al.

Publication

Anaesthesia 2010; 65: 343-347.

Summary

  • To evaluate the use of the LMA Supreme™ in manikins and patients by medical personnel with limited experience of airway management
  • There were no failed insertions of the LMA Supreme™ in either manikins or patients by medical personnel with limited experience of airway management
  • Medical personnel with limited experience of airway management can successfully use the LMA Supreme™

Objectives:

  • To evaluate the use of the LMA Supreme™ in manikins and patients by medical personnel with limited experience of airway management

Method:

  • This prospective study was carried out in two stages
  • The LMA Supreme™ was inserted in manikins in the first stage of the study and in patients in the second phase of the study
    • Eligible medical personnel included non-anaesthetic doctors, medical students, operating department practitioners and anaesthetic and intensive care nurses
    • To participate in the patient phase of the study, medical personnel had to have attended an advanced life support course that included LMA insertion
  • Patients involved in the second phase of the study were American Society of Anesthesiologists physical status 1-3 and were undergoing non-emergency surgery that required general anaesthesia and the use of a supraglottic airway device
  • The study endpoints were
    • Number of insertion attempts
    • Ease of insertion
    • Time taken to achieve an effective airway
    • Adequate ventilation
    • Airway manipulations
    • Complications

Results:

  • Overall, 50 medical personnel were involved in each stage of the study
    • There were 34 male and 16 female patients (median age 38 years; median body weight 77 kg) in the second phase of the study
  • Aspects of insertion of the LMA Supreme™ during both phases of the study are shown in Table 1
    • There were no failed insertions during either phase of the study
  • No complications or significant difficulties were reported in the manikin phase of the study
  • During the patient phase of the study, mechanical ventilation was achieved in all cases
    • Five patients coughed following the insertion of the LMA Supreme™ and in two cases blood was observed on the device when it was re-inserted
    • No important complications (i.e. loss of airway, hypoxia, laryngospasm or bronchospasm) were noted

 

Conclusions:

  • The LMA Supreme™ can be successfully used in both manikins and patients by medical personnel with limited experience of airway management
  • The results of this study suggest that the LMA Supreme™ “is suitable for use by airway novices”

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