Airway Management Evolution – In a Search for an Ideal Extraglottic Airway Device

Abstract

Extraglottic airway devices (EADs) are commonly used equipment for airway maintenance during elective procedures under general anaesthesia. They may be used also in other indications such as conduit for tracheal intubation or rescue airway device in prehospital medicine. Current classifications of the EADs lack systematic approach and therefore classification according to the sealing sites and sealing mechanisms is suggested in this review article. Modern EADs are disposable, latex-free devices made of plastic materials most commonly from polyvinylchloride (PVC). The bowl of uncuffed sealers is manufactured from different materials such as thermoplastic elastomers or ethylene-vinyl-acetate co-polymer. EADs create various physical forces exerted on the adjacent tissues which may contribute to different sealing characteristic of particular device or to variable incidence of postoperative complications. Desired features of an ideal EAD involve easy insertion, high insertion success rate even by inexperienced users, protection against aspiration of gastric contents and low incidence of postoperative complications such as sore throat, hoarseness, cough or swallowing difficulties.

Comparison of Baska Mask® and Classical Laryngeal Mask® for Seal Pressures in Ambulatory Urological Surgery

“…9 Kendiliğinden enerji sağlayan sızdırmaz kaf yapısı üçüncü jenerasyon laringeal maskeler için genel adlandırma olarak söylenmektedir. 10 Üçüncü jenerasyon araçların havayoluna pozitif basınç uygulandıkça daha iyi sızdırmazlık sağla-dıkları, bu basıncın glottis açıklığı etrafındaki silikon yapısına basıncı ilettiği ve havayoluna daha sıkı mühürlendiği üretici firmalar tarafından iddia edilmektedir. Ancak, bu iddiaların klinik olarak doğrulanması ve güvenirliliklerinin sınanması gerekmektedir.…”

Third generation supraglottic airway devices: an undefined concept and misused term. Time for an updated classification of supraglottic airway devices

“…However, why Professor Cook's choice of the term 'generation' is inappropriate 3 and an unfortunate choice is explained in the article that Michalek and I wrote. 2 As I see it, I think that the inappropriate use of 'third generation' by the commercial references, but not academic references, which Professor Cook refers to in his letter, may suffer from the same issue of referring to improved features (aspiration protection, conduit for intubation, bite block etc.) that do not constitute fundamental step changes in the essential function of extraglottic airways as new generations.…”

“…Editor-The term 'third generation supraglottic airway' (SAD) has recently been used in a number of settings, both commercial and promotional, [1][2][3][4] and more recently, in the anaesthetic literature. [5][6][7] As the originator of the classification first and second generation SAD, I am interested in this.…”

The i-gel Supraglottic Airway as a Conduit for Fibreoptic Tracheal Intubation – A Randomized Comparison with the Single-use Intubating Laryngeal Mask Airway and CTrach Laryngeal Mask in Patients with Predicted Difficult Laryngoscopy

“…Supraglottic airway devices (SADs) play an important role in modern anaesthetic practice (Michálek and Miller, 2014). Apart from airway maintenance during selected elective procedures, they may be used in difficult airway management situations.…”