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Advances in Supraglottic Airway

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Presentation on theme: "Advances in Supraglottic Airway"— Presentation transcript:

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


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


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


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