Laryngeal tube S II, laryngeal tube S disposable, Fastrach laryngeal mask and Fastrach laryngeal mask disposable during elective surgery: a randomized controlled comparison between reusable and disposable supraglottic airway devices

Background and objective Analogue disposable devices of the laryngeal tube S II (LTS II) and the Fastrach laryngeal intubation mask (ILMA, Fastrach), namely the laryngeal tube disposable (LTS-D) and the Fastrach laryngeal intubation mask disposable (Fastrach-D), have recently been introduced. The purpose of this study was to compare each reusable device with the corresponding disposable one, during routine surgery. Methods After informed consent, 120 American Society of Anesthesiologists I-III patients scheduled for routine minor surgery were randomly allocated to the LTS II (n=30), the LTS-D (n=30), the Fastrach (n=30) and the Fastrach-D (n=30) groups, respectively. Overall insertion success rates, time to first sufficient ventilation (V(e)t >= 200 ml), resulting airway leak pressures (ALPs), subjective assessment of handling as well as patient comfort were determined. Results Insertion success rates of the LTS II, LTS-D, Fastrach and Fastrach-D were 30/30, 29/30, 30/30 and 30/30, respectively. Time to successful insertion in the LTS II vs. the LTS-D group, as well as in the Fastrach vs. the Fastrach-D group, showed significant differences [median (min - max) s: 38 (13-187), 23 (9-108), P<0,05; 27.5 (6-110), 16 (8-82), P<0.05]. The highest ALP could be observed in the LTS-D group [median (min - max): 40 (16-40), P<0.001 vs. all other devices] and the lowest ALP in the Fastrach-D group [median (min - max): 24.5 (12-40)]. ALP did not differ significantly in any group during variation of cuff volume by +/- 20 ml. Subjective assessment of handling was significantly (P<0.001) better in the LTS-D group than in the LTS II, Fastrach and Fastrach-D groups. Conclusion LTS II, LTS-D, Fastrach and Fastrach-D were all suitable for routine airway management. The LTS-D showed the best properties in terms of airway sealing and handling. Eur J Anaesthesiol 2010;27:468-472