1. Advances in Supraglottic Airway
Dr. K. Sudarshan
Consultant Anaesthetist
Coimbatore

2. Should satisfy the following conditions
Which ones qualify ?
Should satisfy the following conditions

3. 1. Placed above the vocal cord level
2. Those devices which allow hands-free
maintenance of an open airway
3. Allows spontaneous or assisted
ventilation

4. 1908 to date 1908- Hewitt Airway 1983 – Laryngeal Mask – Archie brain
1913- Connell
1915- Lumbard
1916 – Mona Roberts
Phillips
1924 – Poe
1930 – Waters insufflation
1933 – Guedel
1957- Fink vallecular
1957 – Safar Airway
1977 – Berman intubating
1982 – Patil Syracuse
1983 – Laryngeal Mask – Archie brain
1985 – Combitube

5. Sir Frederic William Hewitt 1856 - 1916
A modified version of the original Hewitt airway
The original
Hewitt airway as it
appeared in the
February 15, 1908
issue of The Lancet.

6. Dr.Arthur Guedel

7. Dr.Peter Safar

8. Dr. Archie Brain

9. NASOPHARYNGEAL AIRWAY
COPA
COMBITUBE
NASOPHARYNGEAL AIRWAY

10. Advancements New generation LMA’s I gel Laryngeal Tube/ King LTS/ LTD
Cobra plus tube

11. Generally demonstrate
Ability to be placed without direct visualization
Better cardio vascular stability both during insertion and removal
Minimal IOP and ICP changes
Provide little protection against aspiration
Contraindicated in full stomach patients

12. Proseal & LMA Supreme Has two separate tubes
Three dimensional inflation of cuff
Holds a better cuff seal pressure

13. Flexible & Ambu LMA Flexometallic tube Preformed angle
Better placement
Less incidence of dislodgement once placed
More useful in head and neck surgery

14. ILMA & LMA C Trach
Allows intubation with minimal head and neck manipulation
Recommended in both difficult airway and Resuscitation algorithm
C Trach allows intubation under direct vision

16. Single use, cuffless
Integral gastric channel
Epiglottic blocking ridge
Moulding feature

17. Insertion Technique I GEL INSERTION
I GEL insertion in Lateral position

18. Laryngeal Tube / KING LTS Tube

19. King LTD Design

20. King LTS-D Airway Design

21. INSERTION STEPS Use lateral approach
Introduce the tip into corner of mouth
Advance behind the base of tongue
Without exercising excessive force, advance until the base of the connector is aligned with teeth.
Inflate the cuff

22. FINAL POSITION

23. Laryngeal tube Insetion.

24. Cobra plus tube Distal end has softened openings
Used for both spontaneous and controlled ventilation
Serves as a rescue airway

25. Streamlined liner of Pharyngeal airway - SILPA
Cuffless
Lines the pharynx
Large internal volume –Allows collection of secretion, minimize aspiration

26. Summary Provides hands free maintenance of airway
Can be used for both spontaneous and controlled ventilation
Provide little protection against aspiration
Useful in
Routine anaesthesia
emergency airway management
Aid to intubation

27. THANK YOU