Randomized crossover study assessing oropharyngeal leak pressure and fiber optic positioning. Laryngeal Mask Airway Supreme™ versus Laryngeal Tube LTS II™ size 2 in non-paralyzed anesthetized children

As there are currently no data available comparing the practicability of the laryngeal mask airway (LMA) Supreme (TM) size 2 versus the laryngeal tube LTS II (TM) size 2 in children, this trial was conducted to quantify the differences between these two airway devices concerning leak pressure and fiber optic-controlled positioning in non-paralyzed, anesthetized pediatric patients. A total of 56 children aged 1-6 years and weighing between 11 and 23 kg were enrolled in the study. Anesthesia was intravenously induced according to local standards using fentanyl and propofol. After induction of anesthesia both airway devices were inserted consecutively in accordance with the randomization protocol. The mean oropharyngeal leak pressure was significantly higher for the LTS II (TM) (33 +/- 8 cmH(2)O) than for the LMA Supreme (TM) (21 +/- 7 cmH(2)O, p < 0.0001). Fiber optic position monitoring was better when the LMA Supreme (TM) was used (p < 0.001). The first attempt success rates for insertion (55(Supreme LMA) vs. 43(LTSII), p < 0.001), the insertion time (25 s (Supreme LMA) vs. 34 s (LTSII), p < 0.04) and the frequency of bloodstaining (0(Supreme LMA) vs 4(LTSII), p < 0.04) for the initially used device were better for the LMA Supreme (TM) than the laryngeal tube LTS II (TM). We conclude that oropharyngeal leak pressure, fiber optic position, first attempt insertion success rate and bloodstaining differed between the LMA Supreme (TM) and the LTS II (TM) in children.