[Laryngeal mask LMA Supreme. Application by medical personnel inexperienced in airway management].
BACKGROUND
The Laryngeal Mask Airway Supreme (LMA-S) is a new disposable airway device that combines features of the LMA ProSeal (PLMA, gastric access) and LMA Fastrach (curved shaft to ease insertion) and has been available since April 2007.


METHODS
In a prospective study, 10 final year medical students or first year anesthesia residents, all with limited experience in LMA anesthesia, were requested to manage the airway of anesthetized female patients with the LMA-S size 4, who seemed normal on routine airway examination. Data collection included the success rates and duration for insertion, oropharyngeal leak pressures (OLP), fiber optic position and airway morbidity.


RESULTS
A total of 30 patients were enrolled in the study. Insertion of the LMA-S was possible in 27 (90%) patients at the first attempt and in 3 (10%) at the second attempt. Ventilation was established in 18.3 s (range 10-30 s, standard deviation +/-4.2 s). Insertion of a gastric tube was possible in all patients at the first attempt. Mean OLP at the level of 60 cmH2O cuff pressure was 29.1 cmH2O (range 21-35 cmH2O, standard deviation +/-4.8 cmH2O). Laryngeal fit evaluated by fiber optic control was rated as optimal in all patients both immediately after insertion of the LMA-S and after end of surgery. Three patients (10%) complained of mild sore throat. No patient reported dysphagia or dysphonia.


CONCLUSIONS
Insertion of the LMA-S was successful and possible in all patients in < or = 30 s with an optimal laryngeal fit, high OLPs and low airway morbidity. The LMA-S seems to be a device suitable for use in routine anesthesia and which can be safely used by medical personnel with limited clinical experience.
Timmermann
A
A
Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin, Universitätsmedizin Göttingen, 37099 Göttingen, Deutschland. atimmer@zari.de
Cremer
S
S
Heuer
J
J
Braun
U
U
Graf
B M
BM
Russo
S G
SG
D000399:Air Pressure; D000769:Anesthesia, Inhalation; D000776:Anesthesiology; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007396:Internship and Residency; D007441:Intubation, Gastrointestinal; D017214:Laryngeal Masks / Q000009:adverse effects; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000295:instrumentation; D013337:Students, Medical; D014132:Trachea / Q000293:injuries