Related Experiment Video
Updated: May 20, 2026

Laryngeal Mask Airway (LMA) Placement in a Neonatal Patient Simulator Using a Non-Inflatable Supraglottic Airway (SGA)
Published on: July 14, 2023
Similar oropharyngeal leak pressures during anaesthesia with i-gel, LMA-ProSeal and LMA-Supreme Laryngeal Masks
T C R V Van Zundert1, J R Brimacombe
1Department of Anaesthesia and Intensive Care, Cairns Hospital, James Cook University, Cairns, Queensland, Australia. t.van.zundert@mumc.nl
Introduction:
We test the hypothesis that there are differences in performance among three extra-glottic airway devices during spontaneous breathing anaesthesia.
Methods:
One hundred and fifty consecutive patients (ASA Grade 1-2, aged 18-80 yr) were randomly allocated for airway management with the i-gel (Intersurgical Ltd, Wokingham, Berkshire UK), the LMA-ProSeal and the LMA-Supreme (The Laryngeal Mask Company Ltd, Wooburn Green, Bucks, UK). Anaesthesia was with fentanyl/propofol/sevoflurane mixture. A laryngoscope-guided, gastric tube-guided technique was used for insertion. The following primary variables were assessed: ease of insertion, effective airway time, anatomical position, oropharyngeal leak pressure among devices, and change in oropharyngeal leak pressure between 30 and 60 minutes for each device during the spontaneous breathing anaesthesia.
Results:
Differences detected were that the LMA-Supreme was easier to insert and had a shorter effective airway time than the LMA-Proseal and i-gel. Anatomical position was better for the LMA-Supreme than for the i-gel. Oropharyngeal leak pressures were similar among devices during apnoea and spontaneous ventilation, but much higher than in the first generation classic type of laryngeal masks. There were no changes in oropharyngeal leak pressure for any device during the spontaneous breathing phase. There were no differences in performance for any variable between the LMA-ProSeal and i-gel.
Conclusion:
The LMA-Supreme is easier and quicker to insert than the LMA-ProSeal and i-gel using a laryngoscope-guided, gastric tube-guided technique and is associated with better anatomical positioning than the i-gel. Oropharyngeal leak pressures are similar among devices.
Related Concept Videos
Cardiopulmonary Resuscitation II: ACLS Airway Management
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
Suctioning the Nasopharyngeal Airway
Equipment Required
Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation (NIPPV)
Local Anesthetics: Common Agents and Their Applications
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
