An update: use of laryngeal mask airway devices in patients in the prone position

Some providers advocate using laryngeal mask airways (LMAs) for procedures performed in the prone position to meet the demands of quicker operating room turnover time requirements, staffing reductions and the desire to expedite patient recovery in the postoperative period. We provide an update to a 2010 systemic review examining the use of LMAs in patients in the prone position. Six peer-reviewed articles described the use of LMAs in prone patients: a randomized controlled trial, 2 description studies, a case series, and 2 case reports. The risk of publication bias was possibly high. This evidence, mostly from lower level sources, supports the use of the LMA in this setting, with risks comparable to when LMAs are used in patients in the supine position. Experienced providers should carefully select patients and procedures when considering using LMAs for patients in the prone position. There must be a plan to control the airway if problems are encountered with the LMA. These devices might be considered as a bridge device when a prone patient is accidentally extubated. Additional rigorous studies are needed before use of LMAs in this manner can be widely recommended.