Supraglottic Airway DevicesDiscussion

Abstract

SummarySupraglottic airway devices (SADs) are used to keep the upper airway open to provide unobstructed ventilation. Early (first-generation) SADs rapidly replaced endotracheal intubation and face masks in > 40% of general anesthesia cases due to their versatility and ease of use. Second-generation devices have further improved efficacy and utility by incorporating design changes. Individual second-generation SADs have allowed more dependable positive-pressure ventilation, are made of disposable materials, have integrated bite blocks, are better able to act as conduits for tracheal tube placement, and have reduced risk of pulmonary aspiration of gastric contents. SADs now provide successful rescue ventilation in > 90% of patients in whom mask ventilation or tracheal intubation is found to be impossible. However, some concerns with these devices remain, including failing to adequately ventilate, causing airway damage, and increasing the likelihood of pulmonary aspiration of gastric contents. Careful patient selection and excellent technical skills are necessary for successful use of these devices.

Comparative study between LMA supreme with I-gel in anaesthetised adult patient on effectiveness and safety

“…Second generation SADs allow positive pressure ventilation, are made of disposable materials, have integrated bite blocks, are better able to act as conduits for tracheal tube placement. 8 However, some concerns with these devices remain, including failing to adequately ventilate, causing airway damage, and increasing the likelihood of pulmonary aspiration of gastric contents. 9,10 Careful patient selection and excellent technical skills are necessary for successful use of these devices.…”

“…9,10 Careful patient selection and excellent technical skills are necessary for successful use of these devices. 8 The I-gel and SLMA are second-generation SADs for use during anaesthesia. They have an elliptical bite block which minimizes axial rotation and a small drain tube to prevent gastric tube location and prevent gastric inflation during ventilation.…”

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

“…7,8 İkinci jenerasyon I-Gel ve üçüncü jenerasyon Baska Mask ® gibi kafsız modellerle, kaf yapısına bağlı morbiditelerden korunulduğu ve orofaringeal sızdırmazlıkla ilişkili hava kaçağı ihtimalinin azaldığı vurgulanmıştır. 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.…”

Overinflation of a King LT Extraglottic Airway Device Mimicking Ludwig’s Angina

“…[1][2][3] Indeed, the use of an EGD is recommended as a backup emergency airway device in the event of difficult bag-mask ventilation and failed intubation attempts on numerous difficult airway algorithms. [4][5][6][7] Based on the accepted airway management guidelines, the use of the King LT(S)-D device by paramedics in this case was an appropriate rescue maneuver after failed intubation.…”