A Randomized Crossover Comparison of the Laryngeal Mask Airway Proseal and Laryngeal Mask Airway Supreme in Anesthetized Adult Patients

Abstract

BACKGROUND: Newer supraglottic airway devices have been recently introduced, motivated by the need for a single use equivalent to the reusable LMA Proseal. LMA Supreme is a new single use laryngeal mask airway with gastric access providing an easy, reliable airway and good airway seal. The objectives of the present study were to compare LMA Proseal and LMA Supreme for ease of insertion, oropharyngeal leak pressure and fibre-optic position in anesthetized adult patients. MATERIAL AND METHODS:We conducted a prospective randomized study in 60 ASA grade I and II adult patients posted for elective surgeries under general anesthesia. 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. The ease of insertion, oropharyngeal leak pressure and fibre-optic position were determined. RESULTS: First attempt and overall success of insertion were similar (LMA Proseal 93.33% and 100%; LMA Supreme 96.66% and 100%). Guided insertion was always successful following failed digital insertion. There was no difference in the mean duration of insertion for both the devices (23.92±1.44 vs 23.44±1.72seconds). The mean oropharyngeal leak pressure was significantly higher for the LMA Proseal than the LMA Supreme (23.24 vs 19.37cm of H2O) (p<0.05). The fibre-optic view of the glottis was similar for both the devices. CONCLUSION: In this study, the ease of insertion and fibre-optic position were similar for the LMA Proseal and LMA Supreme, but oropharyngeal leak pressure is higher for the LMA Proseal. The LMA Proseal provides a more effective seal than LMA Supreme for positive pressure ventilation.