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LMA - Model Supreme - A Second Generation Sad with An Innovative Second Seal
LMA Supreme™ is a single use, second generation, gastric access device which forms an effective First Seal™ with the oropharynx (oropharyngeal seal) and an innovative Second Seal™ with the upper oesophageal sphincter (the oesophageal seal). The importance of the Second Seal™ (oesophageal seal) is significant: it can minimise gastric insufflation and reduce the risk of aspiration, giving you the confidence to go further with a laryngeal mask airway.
The NAP4 Report recommends that all hospitals have access to second generation SADs, such as LMA Supreme™, for both routine use and rescue airway management.
LMA Supreme™ delivers the following evidence-based benefits:
- Insertion success: Insertion times as low as 5 seconds from picking up the device to connection to the anaesthetic circuit5
- High ventilation performance: Measured oropharyngeal leak pressures up to 37 cm H203
- Effective gastric access: Regurgitation of gastric contents through the drain tube observed in 4/205 patients with no evidence of aspiration9
- Insertion success with new users: 86% first time insertion success; 100% overall insertion success12
- A viable option in both routine and advanced procedures: Evidence to support use in laparoscopic cholecystectomy, radical retropubic prostatectomy, prone procedures, paediatrics and during CPR 7,8,9,10
Consider using LMA Supreme™ for:
- Mild-to-moderately obese patients.
- Abdominal procedures.
- Controlled reflux.
- Positive pressure ventilation (PPV).
- Unexpected difficult airways.
Second generation devices, such as LMA Supreme™, come highly recommended in the recently published NAP4 audit conducted by the Royal College of Anaesthetists and the Difficult Airway Society, UK.
Recommendation:
If tracheal intubation is not considered to be indicated but there is some (small) increased concern about regurgitation risk, a second generation supraglottic airway is a more logical choice than a first generation one.
Recommendation:
In patients considered to be at low-risk of aspiration who have other factors that mean that use of a SAD is at the limits of normality (e.g. patient position, access to the airway, patient size) consideration should be given to use of a second generation SAD.
Recommendation:
In view of the above recommendations, and the frequency of these circumstances, it is recommended that all hospitals have second generation SADs available for both routine use and rescue airway management.