title: Complications Associated with the Use of Supraglottic Airway Devices in Perioperative Medicine.
abstract: Supraglottic airway devices are routinely used for airway maintenance in elective surgical procedures where aspiration is not a significant risk and also as rescue devices in difficult airway management. Some devices now have features mitigating risk of aspiration, such as drain tubes or compartments to manage regurgitated content. Despite this, the use of these device may be associated with various complications including aspiration. This review highlights the types and incidence of these complications. They include regurgitation and aspiration of gastric contents, compression of vascular structures, trauma, and nerve injury. The incidence of such complications is quite low, but as some carry with them a significant degree of morbidity the need to follow manufacturers' advice is underlined. The incidence of gastric content aspiration associated with the devices is estimated to be as low as 0.02% with perioperative regurgitation being significantly higher but underreported. Other serious, but extremely rare, complications include pharyngeal rupture, pneumomediastinum, mediastinitis, or arytenoid dislocation. Mild short-lasting adverse effects of the devices have significantly higher incidence than serious complications and involve postoperative sore throat, dysphagia, pain on swallowing, or hoarseness. Devices may have deleterious effect on cervical mucosa or vasculature depending on their cuff volume and pressure.
authors.affiliation: Department of Anaesthesia and Intensive Medicine, 1st Medical Faculty, Charles University in Prague and General University Hospital, U Nemocnice 2, 120 21 Prague, Czech Republic; University of East Anglia, Norwich Research Park, Norwich, Norfolk NR4 7TJ, UK.
authors.forename: Pavel
authors.identifier: 0000-0001-8119-5927
authors.initials: P
authors.lastname: Michalek
authors.affiliation: Department of Anaesthetics, Antrim Area Hospital, Bush Road, Antrim BT41 4RD, UK.
authors.forename: William
authors.initials: W
authors.lastname: Donaldson
authors.affiliation: Department of Anaesthesia and Intensive Medicine, 1st Medical Faculty, Charles University in Prague and General University Hospital, U Nemocnice 2, 120 21 Prague, Czech Republic.
authors.forename: Eliska
authors.initials: E
authors.lastname: Vobrubova
authors.affiliation: Department of Anaesthesia and Intensive Medicine, St. Anne University Hospital, Pekarska 53, 656 91 Brno, Czech Republic.
authors.forename: Marek
authors.initials: M
authors.lastname: Hakl
mesh_terms: D060666:Airway Extubation / Q000009:adverse effects* / Q000295:instrumentation; D058109:Airway Management; D003680:Deglutition Disorders / Q000473:pathology / Q000628:therapy; D017558:Elective Surgical Procedures; D006801:Humans; D059035:Perioperative Period; D010612:Pharyngitis / Q000473:pathology; D010614:Pharynx / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000503:physiopathology*