Dr. Chris Di Capua and Dr. Bryan Glezerson (@BryanGlezerson) join the show to discuss the literature around the risk of aspiration with LMAs compared to ETTs.

This is an episode produced from the Depth of Anesthesia Podcast Elective that’s available to MGH anesthesia residents. Special thanks to Dr. Saddawi-Konefka for supporting the initiative.

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Music by Stephen Campbell, MD.

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References

Keller C, Sparr HJ, Luger TJ, Brimacombe J. Patient outcomes with positive pressure versus spontaneous ventilation in non-paralysed adults with the laryngeal mask. Can J Anaesth. 1998 Jun;45(6):564-7. doi: 10.1007/BF03012709. PMID: 9669012.

Bernardini A, Natalini G. Risk of pulmonary aspiration with laryngeal mask airway and tracheal tube: analysis on 65 712 procedures with positive pressure ventilation. Anaesthesia. 2009 Dec;64(12):1289-94. doi: 10.1111/j.1365-2044.2009.06140.x. Epub 2009 Oct 23. PMID: 19860753.

Qamarul Hoda M, Samad K, Ullah H. ProSeal versus Classic laryngeal mask airway (LMA) for positive pressure ventilation in adults undergoing elective surgery. Cochrane Database Syst Rev. 2017;7(7):CD009026. Published 2017 Jul 20. doi:10.1002/14651858.CD009026.pub2

Maltby JR, Beriault MT, Watson NC, Fick GH. Gastric distension and ventilation during laparoscopic cholecystectomy: LMA-Classic vs. tracheal intubation. Can J Anaesth. 2000 Jul;47(7):622-6. doi: 10.1007/BF03018993. PMID: 10930200.

Kim D, Park S, Kim JM, Choi GS, Kim GS. Second generation laryngeal mask airway during laparoscopic living liver donor hepatectomy: a randomized controlled trial. Nature. 2021 Feb 11;11(1):3532. doi: 10.1038/s41598-021-83173-5. PMID: 33574495; PMCID: PMC7878811.

Parikh SS, Parekh SB, Doshi C, Vyas V. ProSeal Laryngeal Mask Airway versus Cuffed Endotracheal Tube for Laparoscopic Surgical Procedures under General Anesthesia: A Random Comparative Study. Anesth Essays Res. 2017;11(4):958-963. doi:10.4103/aer.AER_97_17

Park SK, Ko G, Choi GJ, Ahn EJ, Kang H. Comparison between supraglottic airway devices and endotracheal tubes in patients undergoing laparoscopic surgery: A systematic review and meta-analysis. Medicine (Baltimore). 2016 Aug;95(33):e4598. doi: 10.1097/MD.0000000000004598. PMID: 27537593; PMCID: PMC5370819.

White LD, Thang C, Hodsdon A, Melhuish TM, Barron FA, Godsall MG, Vlok R. Comparison of Supraglottic Airway Devices With Endotracheal Intubation in Low-Risk Patients for Cesarean Delivery: Systematic Review and Meta-analysis. Anesth Analg. 2020 Oct;131(4):1092-1101. doi: 10.1213/ANE.0000000000004618. PMID: 32925330.

Halaseh BK, Sukkar ZF, Hassan LH, Sia AT, Bushnaq WA, Adarbeh H. The use of ProSeal laryngeal mask airway in caesarean section--experience in 3000 cases. Anaesth Intensive Care. 2010 Nov;38(6):1023-8. doi: 10.1177/0310057X1003800610. PMID: 21226432.

Nicholson A, Cook TM, Smith AF, Lewis SR, Reed SS. Supraglottic airway devices versus tracheal intubation for airway management during general anaesthesia in obese patients. Cochrane Database Syst Rev. 2013 Sep 9;(9):CD010105. doi: 10.1002/14651858.CD010105.pub2. PMID: 24014230.