SummaryThe LMA Supreme TM is a new extraglottic airway device which brings together features of the LMA ProSeal TM , Fastrach TM and Unique TM . We test the hypothesis that ease of insertion, oropharyngeal leak pressure, fibreoptic position and ease of gastric tube placement differ between the LMA ProSeal TM and the LMA Supreme TM in paralysed anesthetised patients. Ninety-three females aged 19-71 years were studied. Both devices were inserted into each patient in random order. Two attempts were allowed. Digital insertion was used for the first attempt and guided insertion for the second attempt. Oropharyngeal leak pressure and fibreoptic position were determined during cuff inflation from 0 to 40 ml in 10 ml increments. Gastric tube insertion was attempted if there was no gas leak from the drain tube. First attempt and overall insertion success were similar (LMA ProSeal TM , 92% and 100%; LMA Supreme TM 95% and 100%). Guided insertion was always successful following failed digital insertion. Oropharyngeal leak pressure was 4-8 ml higher for the LMA ProSeal TM over the inflation range (p < 0.001). Intracuff pressure was 16-35 cm higher for the LMA ProSeal TM when the cuff volume was 20-40 ml (p < 0.001). There was an increase in oropharyngeal leak pressure with increasing cuff volume from 10 to 30 ml for both devices, but no change from 0 to 10 ml and 30-40 ml. There were no differences in the fibreoptic position of the airway or drain tube. The first attempt and overall insertion success for the gastric tube was similar (LMA ProSeal TM 91% and 100%; LMA Supreme TM 92% and 100%). We conclude that ease of insertion, gastric tube placement and fibreoptic position are similar for the LMA ProSeal The LMA Supreme TM is a new extraglottic airway device which brings together features of both the LMA ProSeal TM [1] (high seal cuff, gastric access and bite block -to facilitate ventilation, airway protection and airway obstruction, respectively), the LMA Fastrach features are that the airway tube incorporates a drain tube within its lumen to shorten and straighten its path, it is oval-shaped to match the shape of the mouth and to reduce rotation in the pharynx, the inner cuff has been strengthened to prevent airway obstruction from infolding and epiglottic fins have been added to prevent airway obstruction from epiglottic downfolding. The only published data on the Supreme is a pilot study

Summary Following hand disinfection, 40 anaesthetists working in the operating room (OR) were asked to use their personal in‐hospital mobile phone for a short phone call. After use of the cell phone, bacterial contamination of the physicians' hands was found in 38/40 physicians (4/40 with human pathogen bacteria). After repeating the same investigation with fixed phones in the OR anteroom 33/40 physicians showed bacterial contamination (4/40 with human pathogen bacteria). The benefit of using mobile phones in the OR should be weighed against the risk for unperceived contamination. The use of mobile phones may have more serious hygiene consequences, because, unlike fixed phones, mobile phones are often used in the OR close to the patient.

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During emergence from anaesthesia in the knee-elbow position, TIVA is associated with significantly less coughing and reduced haemodynamic response when compared with BAL.

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