The effect of a cervical collar on the seal pressure of the LMA Supreme™: a prospective, crossover trial

The effect of a cervical collar on the seal pressure of the LMA Supreme™: a prospective, crossover trial

Summary For personnel inexperienced in airway management, supraglottic airway devices may be the first choice in an emergency. Changing head position is known to reduce the seal pressure of a laryngeal mask airway. The aim of this study was to investigate whether the use of a cervical collar improve...

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Bibliographic Details
Published in:Anaesthesia Vol. 67; no. 11; pp. 1260 - 1265
Main Authors: Mann, V., Spitzner, T., Schwandner, T., Mann, S. T. W., Müller, M., Ahlbrandt, J., Weigand, M. A., Röhrig, R.
Format: Journal Article
Language:English
Published: Oxford, UK Blackwell Publishing Ltd 01-11-2012
Wiley-Blackwell
Subjects:
Adult
Aged
Aged, 80 and over
Air Pressure
Airway management
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Body Mass Index
Cross-Over Studies
Emergency medical care
External Fixators
Female
Head
Humans
Laryngeal Masks
Male
Medical sciences
Middle Aged
Neck
Obesity - complications
Obesity - physiopathology
Preanesthetic Medication
Prospective Studies
Restraint, Physical
Sample Size
Young Adult
Anesthesia
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Summary:Summary For personnel inexperienced in airway management, supraglottic airway devices may be the first choice in an emergency. Changing head position is known to reduce the seal pressure of a laryngeal mask airway. The aim of this study was to investigate whether the use of a cervical collar improves the stability of airways secured with the LMA Supreme™ (The Laryngeal Mask Company Limited, Mahé, Seychelles). In this crossover trial, the primary endpoint was the difference in the seal pressure of the LMA Supreme in anaesthetised patients in maximum passive extension of the neck, with and without a cervical collar. The median (IQR [range]) seal pressure was 18 (13.8–22.1 [0–30]) cmH2O in maximum passive extension without a cervical collar. With a cervical collar in place, the seal pressure increased to 28 (22.8–30 [17–30]) cmH2O (p < 0.001). In the neutral head position, the seal pressure was 22 (17.6–24.5 [12–30]) cmH2O without and 27 (22–30 [12–30]) cmH2O with a cervical collar in place (p < 0.001). We found that a cervical collar stabilises the airway with an LMA Supreme in place and we recommend this combination for (pre‐hospital) emergency cases.
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content type line 23
ISSN:0003-2409
1365-2044
DOI:10.1111/j.1365-2044.2012.07303.x