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™. Abbreviations: SAD - Supraglottic airway device; ETI - Endotracheal intubation; LMA - Laryngeal mask airways; PPV - Positive pressure ventilation; OLP - oropharyngeal leak pressure Key words: LMA ProSeal™, LMA Supreme™, Oropharyngeal leak pressure; Airway; Aieway management Citation: Singh A, Kaur J, Kaur S, Gupta KK. Safety and efficacy of LMA Supreme™ vs. LMA ProSeal™ for ambulatory surgeries in adult patients. Anaesth. pain intensive care 2021;26(1):63-68. DOI: 10.35975/apic.v26i1.1769 Received: June 02, 2021, Reviewed: December 13, 2021, Accepted: December 15, 2021