Comparison of Different Cuff Pressure Use with the Supreme Laryngeal Mask Airway on Haemodynamic Response, Seal Pressure and Postoperative Adverse Events: A Prospective Randomized Study [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. 2018; 46(2): 151-157 | DOI: 10.5152/TJAR.2017.89587  

Comparison of Different Cuff Pressure Use with the Supreme Laryngeal Mask Airway on Haemodynamic Response, Seal Pressure and Postoperative Adverse Events: A Prospective Randomized Study

Achmet Ali1, Demet Altun1, Nukhet Sivrikoz1, Mesut Yornuk1, Namigar Turgut2, İbrahim Özkan Akıncı1
1Department of Anaesthesiology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
2Department of Anaesthesiology, Okmeydanı Training and Research Hospital, İstanbul, Turkey

Objective: The Supreme™ laryngeal mask airway (SLMA) is a supra glottic airway (SGA) device that is used as an alternative to endotracheal tubes. In the present study, we aimed to compare the use of the SLMA with normal cuff pressure and low cuff pressure, primarily for haemodynamic response.
Methods: In the present study, 120 patients diagnosed with hypertension and scheduled for varicose vein or inguinal hernia operation were enrolled and 99 patients finished. Using randomization, patients were divided into two groups according to cuff pressure as a low-pressure group (Group L, 45 cm H2O) and a normal-pressure group (Group N, 60 cm H2O). Demographics, Mallampati score and the type and duration of surgery, heart rate (HR), mean arterial pressure (MAP), percentage of tidal volume leakage, Ppeak, Pmean, etCO2, seal pressure, fibreoptic scores and postoperative adverse effects of all patients were recorded.
Results: MAP and HR values immediately and 2 minutes after SLMA insertion were significantly lower in Group L (p<0.001). In Group L and Group N, the seal pressures were 24.1±3.1 cm H2O and 26.2±3.9 cm H2O, respectively (p=0.003). Also, blood staining and sore throat occurred less frequently in Group L (p<0.05). The fibreoptic average score, insertion features and ventilation parameters were similar between the groups (p>0.05).
Conclusion: SLMA use with a cuff pressure of 45 cm H2O significantly decreases haemodynamic response and post-operative side effects compared with a normal cuff pressure. Therefore, except for some specific surgeries that require higher seal pressures, we recommend the use of the SLMA with cuff pressures as low as 45 cm H2O.

Keywords: Laryngeal mask airway supreme, general anaesthesia, haemodynamic response, cuff pressure, seal pressure.


Achmet Ali, Demet Altun, Nukhet Sivrikoz, Mesut Yornuk, Namigar Turgut, İbrahim Özkan Akıncı. Comparison of Different Cuff Pressure Use with the Supreme Laryngeal Mask Airway on Haemodynamic Response, Seal Pressure and Postoperative Adverse Events: A Prospective Randomized Study. Turk J Anaesthesiol Reanim. 2018; 46(2): 151-157

Corresponding Author: Achmet Ali, Türkiye


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