The Laryngeal Mask Airway Supremeâ„¢: safety and efficacy during gynaecological laparoscopic surgery

Abstract

Background: Laryngeal Mask Airway Supremeâ„¢ (LMA Supremeâ„¢) is a new single-use polyvinyl chloride supraglottic device that offers gastric access. To date, studies that have tested the LMA Supremeâ„¢) for use in laparoscopic surgery have been reported. We present the largest evaluative study that describes the use of this mask for anaesthesia in gynaecological laparoscopic surgery. Method: Hospital ethics board approval was obtained, and 140 fasted patients undergoing elective gynaecological laparoscopy were prospectively studied. We evaluated the ease of insertion of the device and the drain tube, the oropharyngeal leak pressure (OLP), incidence of postoperative sore throat, and other adverse events. Results: Insertion of the LMA Supremeâ„¢ was successful in all patients (first attempt, n = 123; second attempt, n = 16; and third attempt, n = 1). Gastric tube insertion was successful in all patients (easy, n = 135; difficult, n = 5). Initial mechanical ventilation was adequate in almost all cases. Mean OLP at the level of 60 cmH₂O cuff pressure was 28.2 ± 5.1 cmH₂O. Mean peak airway pressure before pneumoperitoneum was 17± 3.5 cmH₂O, and 22.1 ± 4 cmH2O, after pneumoperitoneum. Fourteen patients (10%) complained of a mild sore throat postoperatively. Coughing occurred in 10 patients (7.1%), and blood was noted after removal of the LMA Supremeâ„¢ in five cases (3.5%). No other complications were reported. Conclusion: We conclude that LMA Supremeâ„¢ is an easy to insert, and effective ventilatory device, for gynaecological laparoscopic surgery. It provides a functional airway seal with minimum adverse events.