A new supraglottic airway device: LMA-supreme, comparison with LMA-Proseal

The LMA-Supreme() (S-LMA()) is a new supraglottic airway device that presents combined features of flexibility, curved structure and single use and a different cuff structure. The purpose of this study was to compare the oropharyngeal leak pressures (OLP) of LMA-Proseal() (P-LMA()) and S-LMA().

Sixty adult patients were prospectively and randomly allocated to undergo insertion of P-LMA() (n=30) or S-LMA() (n=30). The cuffs were inflated until the intracuff pressure (ICP) reached 60 cm H(2)O. Orogastric leak pressures, insertion times, first attempt success rates, fiberoptical assessment of position, cuff pressures, orogastric tube (OGT) placement and OGT insertion times were compared. Unblinded observers collected intraoperative data and blinded observers collected post-operative data.

The first insertion attempts and time taken to provide an effective airway were similar between the groups. Two patients (P-LMA(), n=1; S-LMA(), n=1) were intubated due to excessive oropharyngeal leak and in one patient (P-LMA(), n=1) due to failed OGT placement. OLPs were similar (P-LMA(); 26.9+/-6.6 S-LMA(); 26.1+/-5.2). ICP increased significantly in the P-LMA() at the 30 and 60 min during anesthesia (P-LMA(); 80.1+/-12.8, 92.9+/-14.4, S-LMA(); 68.3+/-10.9, 73.7+/-15.6). OGT placement was successful in all patients in the S-LMA(), but failed in five patients in the P-LMA() (P=0.02). Fiberoptically determined anatomic position was better with the P-LMA() (P=0.03).

Our findings suggest that S-LMA() had leak pressures similar to the P-LMA(), and this new airway device proved to be successful during both spontaneous and positive pressure ventilation.