I don’t consider myself fashionable or “brand aware” by any means, but I do get a chuckle every time I reach for a particular laryngeal mask airway (LMA) – the LMA Supreme™. Makes me feel a little bougie. 😉
LMAs were created in the 1980s by Dr. Archie Brain, a British anesthetist, as an easy technique to provide ventilatory support; however, because LMAs sit above the glottic opening, they are not considered a “secure airway.” Over the years, I’ve used several different LMAs (Classic, Unique, i-gel, Fastrach), but the Supreme remains my favorite in relatively quick surgeries where patients are low risk for aspiration.
I feel that the LMA Supreme’s shape and slightly stiffer design allow it to sit better in the posterior oropharynx. Having an additional port for a gastric tube placement is also helpful if I want to evacuate gastric contents throughout the operation and prior to emergence from general anesthesia.
Drop me a comment with your favorite LMA and the reasoning for it!
When I trained in UK deep extubation is almost always the the norm after elective surgery when there is no difficulty with the airway. Use of N2O made it even easier.Patients are also turned left lateral side to prevent aspiration and also to maitain the airway.That was the routine exercise.
Thanks for sharing your experience!