title: A randomized prospective controlled trial comparing the laryngeal tube suction disposable and the supreme laryngeal mask airway: the influence of head and neck position on oropharyngeal seal pressure.
abstract: The Laryngeal Tube Suction Disposable (LTS-D) and the Supreme Laryngeal Mask Airway (SLMA) are second generation supraglottic airway devices (SADs) with an added channel to allow gastric drainage. We studied the efficacy of these devices when using pressure controlled mechanical ventilation during general anesthesia for short and medium duration surgical procedures and compared the oropharyngeal seal pressure in different head and-neck positions.
  
  
  
  Eighty patients in each group had either LTS-D or SLMA for airway management. The patients were recruited in two different institutions. Primary outcome variables were the oropharyngeal seal pressures in neutral, flexion, extension, right and left head-neck position. Secondary outcome variables were time to achieve an effective airway, ease of insertion, number of attempts, maneuvers necessary during insertion, ventilatory parameters, success of gastric tube insertion and incidence of complications.
  
  
  
  The oropharyngeal seal pressure achieved with the LTS-D was higher than the SLMA in, (extension (p=0.0150) and right position (p=0.0268﻿﻿ at 60 cm H2O intracuff pressures and nearly significant in neutral position (p = 0.0571). The oropharyngeal seal pressure was significantly higher with the LTS-D during neck extension as compared to SLMA (p= 0.015). Similar oropharyngeal seal pressures were detected in all other positions with each device. The secondary outcomes were comparable between both groups. Patients ventilated with LTS-D had higher incidence of sore throat (p = 0.527). No major complications occurred.
  
  
  
  Better oropharyngeal seal pressure was achieved with the LTS-D in head-neck right and extension positions , although it did not appear to have significance in alteration of management using pressure control mechanical ventilation in neutral position. The fiberoptic view was better with the SLMA. The post-operative sore throat incidence was higher in the LTS-D.
  
  
  
  ClinicalTrials.gov ID: NCT02856672 , Unique Protocol ID:BnaiZionMC-16-LG-001, Registered: August 2016.
authors.affiliation: Anesthesiology Department, Bnai Zion Medical Center and Bruce and Ruth Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Somri
authors.affiliation: Anesthesiology Department, Penn State College of Medicine, Hershey, PA, USA.
authors.forename: Sonia
authors.initials: S
authors.lastname: Vaida
authors.affiliation: Anesthesiology Department, Hospital Universitario Italiano, Buenos Aires, Argentina.|International Program of Teaching and Investigation in Airway Management - FIDIVA, Haifa, Israel.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Garcia Fornari
authors.affiliation: Anesthesiology Department, Hospital Universitario Italiano, Buenos Aires, Argentina.|International Program of Teaching and Investigation in Airway Management - FIDIVA, Haifa, Israel.
authors.forename: Gabriela Renee
authors.initials: GR
authors.lastname: Mendoza
authors.affiliation: Anesthesiology Department, Hospital Universitario de Valencia, Valencia, Spain.|International Program of Teaching and Investigation in Airway Management - FIDIVA, Haifa, Israel.
authors.forename: Pedro
authors.initials: P
authors.lastname: Charco-Mora
authors.affiliation: Anesthesiology Department, Bnai Zion Medical Center and Bruce and Ruth Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
authors.forename: Naser
authors.initials: N
authors.lastname: Hawash
authors.affiliation: Surgery Department, Bnai Zion Medical Center and Bruce and Ruth Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Matter
authors.affiliation: Surgery Department, Bnai Zion Medical Center and Bruce and Ruth Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
authors.forename: Forat
authors.initials: F
authors.lastname: Swaid
authors.affiliation: Anesthesiology Department, Bnai Zion Medical Center and Bruce and Ruth Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel. luis.gaitini@gmail.com.|International Program of Teaching and Investigation in Airway Management - FIDIVA, Haifa, Israel. luis.gaitini@gmail.com.
authors.forename: Luis
authors.identifier: 0000-0003-2511-9801
authors.initials: L
authors.lastname: Gaitini
mesh_terms: D000328:Adult; D000368:Aged; D058109:Airway Management / Q000295:instrumentation / Q000379:methods*; D000768:Anesthesia, General / Q000379:methods; D004867:Equipment Design; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D010612:Pharyngitis / Q000453:epidemiology; D011187:Posture; D011312:Pressure; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods*; D016037:Single-Blind Method; D013396:Suction / Q000295:instrumentation
keywords: Laryngeal tube; Oropharyngeal seal pressure; Supreme laryngeal mask airway