Comparison of insertion characteristics between LMA- Supreme and Laryngeal tube with suction in patients undergoing short duration surgery: a prospective analytical cohort study

Abstract

Background & Objective: A number of supraglottic airway devices (SADs) are being used for airway management and newer devices are being introduced. This study compared insertion characteristics of two SADs namely LMA Supreme (LMAS) and Laryngeal tube with suction (LTS) in short duration surgery, including insertion success rate, ease of insertion, time taken to insert and the number of attempts required to secure the airway.

Methodology: This prospective analytical cohort study compared the insertion characteristics for two devices in short duration surgeries. Sixty six ASA Class I and II patients were divided into two groups of 33 each.

Insertion characteristics of the two airway devices were assessed for insertion success rate, ease of insertion, number of insertion attempts, time required for successful insertion and leak pressure. Ease and time for insertion of Ryle’s tube, hemodynamic and respiratory parameters during and immediately post insertion as well as postoperative airway morbidity (sore throat, dysphagia and hoarseness) was also compared.

Statistical analysis: Data was analyzed with SPSS statistical software. Statistical significance: p value < 0.05 was considered to be statistically significant.

Results: Both LMAS and LTS secured effective airway in less than 30 sec. LTS was inserted in first attempt in 69.7% patients compared to 84.8% in LMAS group. LTS was easy to insert with no resistance in 42.4% patients and LMAS in 69.7% patients. Mean time for establishment of an effective airway was 24.06 ± 2.54 sec and 20.39 ± 2.19 sec with LTS and LMAS respectively while for Ryle’s tube (RT) insertion it was 18.70 ± 2.40 and 17.27 ± 2.30 sec. LMAS was associated with lower leak pressure and thus lower incidence of laryngotracheal complications.

Conclusion: Both LMAS and LTS are useful alternatives to endotracheal intubation and provide effective and safe airway within 30sec. Success rate of insertion at first attempt is higher with LMAS. The LMAS was easier and faster to insert than the LTS and RT insertion was easier and faster through LMAS. The airway leak pressure was higher with LTS. Both devices are associated with minimal hemodynamic response. Incidence of post-operative airway morbidity was less with LMAS. LMAS was found to be a reliable and better airway management option for patients undergoing short surgical procedures under general anesthesia.