Safety and efficacy of LMA Supreme™ vs. LMA ProSeal™ for ambulatory surgeries in adult patients

Abstract

Background & objectives: The laryngeal mask airway Supreme™ (LMA-S) is a new, single-use, supraglottic device that combines the functionality of the ProSeal™ and Fastrach™ airways. Till now, there have been conflicting results regarding the oropharyngeal leak pressure (OLP) of the LMA Supreme™ vs. the LMA ProSeal™, which is the major determinant of effective ventilation and airway protection during LMA use. We compared the safety and efficacy of the LMA ProSeal™ vs. the LMA Supreme™ in ambulatory surgeries. Methodology: In this prospective, comparative trial, eighty adult patients undergoing elective surgery, were randomly allocated to one of the two groups: Group LMA-P (LMA ProSeal™ group) and Group LMA-S (LMA Supreme™ group) of 40 patients each. OLP, insertion times, number of insertion attempts, ease of insertion and pharyngolaryngeal morbidity were assessed. Statistical analysis was performed using SPSS version 21.0 software using Student's t-test and Chi-square test. P < 0.05 was considered to be statistically significant. Results: Oropharyngeal leak pressure in Group LMA-P (26.65 ± 1.59 cmH2O) was comparable to Group LMA-S (26.08 ± 1.67 cmH2O) and both provided adequate seal and effective ventilation. The mean effective airway time was significantly less in Group LMA-S as compared to Group LMA-P (14.80 ± 1.24 sec and 17.80 ± 1.47 sec) respectively. Mean number of successful insertion attempts, hemodynamic response and pharyngolaryngeal morbidity were comparable in both the groups. Conclusion: Both LMA Supreme™ and LMA ProSeal™ are equally efficacious and safe for maintaining airway and ventilation in paralyzed patients. However, LMA Supreme™ is easier to insert with shorter effective airway time than LMA ProSeal™.