Poster presentation ISACON Kolkata

1. SECOND GENERATION SUPRAGLOTTIC DEVICES
SUCCESSFUL IN BRIDGING THE GAP
BY: DR ABHINAV CHAUDHARY
JUNIOR RESIDENT, IGGMC, NAGPUR
GUIDED BY: DR SANDHYA MANJREKAR, Proffessor and HOD
DR VAISHALI SHELGAONKAR , Associate Professor

2. LMA PROSEAL (Dr Archie Brian)
•First SGA with two tubes, flexible and wire reinforced.
•Large ventral cuff and a smaller dorsal cuff; improves
leak pressure(30cm water).
•Deeper bowl traversed by drainage tube,eliminates the
need for aperture bar.
•Drainage tube minimizes risk of aspiration,helps in
determining the correct position
•Available with an introducer; In seven sizes,maximum of
18Fr nasogastric inserted.

3. I GEL (Dr Mohammed Nasir)
•Made up of gel like thermoelastic elastomer, soft and
conforms the hypopharynx providing an impression seal.
•Integral gastric channel, passage for nasogastric tube.
•Epiglottic rest prevents the epiglottis from down falling.
•Buccal cavity stabilizer.
•After insertion tip located in the upper oesophageal
opening, cuff sits against the laryngeal framework, incisor
resting on integral bite block.
•As cuffless easier insertion, minimum tissue compression
•Available in seven sizes; size 1 lacks drainage tube

4. LMA SUPREME
•Elliptical and anatomically shaped airway tube facilitating
successful insertion.
•Elongated cuff with a narrower transverse diameter.
•Fins within the bowl of mask protects from epiglottic
obstruction.
•Anatomical conformity – low volume inflation enable
conformity of mask to oropharyngeal anatomy.
•Optimise distal tip with gastric access – internal webbing
keeps drain tube open.
•Fixation tab, Meniscus sign.
•Most commonly used LMA.

5. Largngeal tube suction
•Silicon tubes with two cuffs, large proximal pharyngeal,
smaller distal oesophageal, single inflation line
•Ventilating lumen located between the two cuffs
•Inserted blindly into the oesophagus, distal cuff seals
oesophagus and proximal sits in oropharynx.
•Suction channel opens at the distal end through an extra
tube running at the back.
•Colour coded syringe specifying the amount of air for
respective sizes.
•Limited functionality as a conduit, glottic placement.

6. SLIPA (Dr Donald Miller)
•Inexpensive single use alternative, cuff less device,
has an enlarged cavity for trapping regurgitant fluids.
•Boot shaped with a toe bridge and heel prominence;
toe sits at oesopharyngeal entrance, bridge fits pyriform
fossa and heel anchors the device into position with the
soft palate.
•Rigid at room temperature but softens on insertion.
•Available in six sizes; appropriate size selected by
matching with the widest part of patients larynx.
•Lesser incidence of sore throat.

7. REFERENCES
• Time to abandon the 'vintage' laryngeal mask airway and adopt second generation supraglottic
airway devices as first choice; BJA Oct 2015; T. M. Cook, F.E Kelly
• Supraglottic airway devices : recent advances; T. M. Cook, Ben Howes; continuing education in
anaesthesia ; Nov 2011
• Comparison of seal in seven supraglottic airway devices using a cadaver model of elevated
esophageal pressure; Bercker, Schmidbauer,; anaesthesia and analgesia;, Feb 2008
• I gel a new revolution among supraglottic airway devices ;M. E. J2009 2009, anaesthesia
• Evolution of extra glottal airway a review of its history, applications and practical tips for
success ;Michael, Allan, Adranik; Feb 2012; anaesthesia analgesia
• Evolution of airway devices ;JP; Vaishali, Kavita, Archana