A comparison of the supreme™ laryngeal mask airway with the proseal™ laryngeal mask airway in anesthetized paralyzed adult patients: A randomized crossover study

Abstract

Purpose: 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 H2O. 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 H2O and 20.9 ± 6.7 cm H2O 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). Conclusion: 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. © 2010 Canadian Anesthesiologists' Society.