A comparison of the Supreme laryngeal mask airway with the Proseal laryngeal mask airway in anesthetized paralyzed adult patients: a randomized crossover study.
OBJECTIVE
The Supreme laryngeal mask airway (SLMA) is a new single-use advanced form of the Proseal laryngeal mask airway (PLMA). This study tested the hypothesis that the SLMA is equally as effective as the PLMA as a supraglottic ventilatory device in anesthetized paralyzed adult patients.


METHODS
Size 4 SLMAs and PLMAs were compared in a randomized crossover study involving 60 patients aged 21-75 yr and American Society of Anesthesiologists physical status I and II. Once the patients were anesthetized and paralyzed, the SLMA and the PLMA were inserted into each patient in random order. The primary outcome measure was the laryngeal seal pressure (LSP) at an intracuff pressure of 60 cm H(2)O. Secondary outcome measures included the ease of inserting the laryngeal mask airway devices (LMADs) and the fibreoptic position of the airway tube.


RESULTS
There was no statistically significant difference in LSP between the SLMA and the PLMA. The mean LSP was 19.6 +/- 5.8 cm H(2)O and 20.9 +/- 6.7 cm H(2)O for the SLMA and the PLMA, respectively. There was a similarity between the SLMA and the PLMA regarding the number of attempts required and the duration for insertion. However, fibreoptic positioning was better with the PLMA than with the SLMA (P < 0.0001).


CONCLUSIONS
The clinical performance of the SLMA as a ventilatory device is comparable with that of the PLMA, as illustrated by the similar LSPs. The inferior position of the SLMA airway tube compared with that of the PLMA does not affect its ease of ventilation.
Tham
Huae Min
HM
Department of Anaesthesia and Surgical Intensive Care, Changi General Hospital, Singapore, Singapore. huae_min@hotmail.com
Tan
Su Meng
SM
Woon
Kwee Lian
KL
Zhao
Yu Dong
YD
D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation; D001279:Atracurium; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007441:Intubation, Gastrointestinal; D017214:Laryngeal Masks; D007828:Laryngoscopy; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents; D055100:Optical Fibers; D012044:Regression Analysis; D012121:Respiration, Artificial; D014132:Trachea / Q000033:anatomy & histology; D055815:Young Adult
D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium