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J Anesth. 2011 Aug;25(4):535-9. doi: 10.1007/s00540-011-1145-0. Epub 2011 Apr 12.

Comparison of Laryngeal Mask Supreme® and Soft Seal® for airway management in several positions.

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Department of Anesthesiology, Hyogo College of Medicine, Mukogawa-cho 1-1, Nishinomiya, Hyogo 663-8501, Japan.



In emergency situations, rescuers occasionally must secure the airway while the patient is in a position other than the ideal supine position. We hypothesized that the laryngeal mask airway Supreme(®) (Supreme) may be useful for emergent airway management in several positions and compared the utility of the Supreme with that of the conventional Soft Seal(®) (Soft Seal) device.


Nineteen novice doctors in our anesthesia department attempted insertion of the Supreme or Soft Seal device on a simulated manikin in the supine, left lateral decubitus (left-LT), right lateral decubitus (right-LT), prone, and sitting positions. For each device, successful ventilation attempts, mean time to secure the airway, and difficulty of use [using the visual analog scale (VAS)] were evaluated.


The success rate of ventilation was significantly higher with the Supreme than the Soft Seal in the prone and sitting positions (P < 0.05). Compared with the Soft Seal, time to secure the airway was significantly shorter with the Supreme when the manikin was in the sitting position but not in the other four positions. VAS scores for Supreme use were significantly higher than those for Soft Seal use in the right-LT, prone, and sitting positions.


Airway management attempts by novice doctors were more successful with the Supreme than the Soft Seal in the right-LT, prone, and sitting positions in the manikin. The Supreme may therefore be useful for emergent airway management.

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