Comparison of streamlined liner of the pharynx airway (SLIPA^™) and laryngeal mask airway: a systematic review and meta‐analysis

Abstract

SummaryWe performed a systematic review to compare the efficacy and safety of the streamlined liner of the pharynx airway and laryngeal mask airway used in adults during general anaesthesia. We included 14 studies with studies with 1273 patients in total. There was no evidence of a difference between the two devices in insertion success rate on the first attempt (13 studies, 1143 patients), insertion time (seven studies, 576 patients), ease of insertion (five studies, 466 patients), oropharyngeal leak pressure (eight studies, 771 patients) and the quality of the fibreoptic view of the larynx through the device (three studies, 281 patients). The relative risk (95% CI) of bloodstaining of the device (nine studies, 859 patients) was 2.09 (1.46-3.00) for the streamlined liner of the pharynx airway compared with the laryngeal mask airway. Other adverse events were comparable. Subgroup analysis suggested that the insertion by novice users might be faster and more successful with the streamlined liner of the pharynx airway than the laryngeal mask airway; however, this was from only two studies and 186 patients. The method of size selection of the streamlined liner of the pharynx airway device might also affect the speed of insertion: choosing according to the width of the patient's thyroid cartilage, rather than height, may produce better results.

Pre-warming the Streamlined Liner of the Pharynx Airway (SLIPA™) improves fitting to the laryngeal structure: a randomized, double-blind study

“…The severity of postoperative throat pain was reduced by pre-warming the SLIPA, but the incidence of blood staining did not differ between the two groups. We expected that as an indicator of a direct trauma to the pharyngeal mucosa, the incidence of blood staining also would be further reduced by pre-warming the SLIPA; however, the incidence was similar between the groups, in line with the findings of previous research [ 4 ]. In addition, pre-warming the SLIPA slightly softens the device, resulting in reduced throat pain, but the incidence of blood staining was not reduced because of the relatively large chamber of the SLIPA for preventing aspiration by regurgitation.…”

“…In addition, the SLIPA is stiffer than other SADs, and this leads to an increase in the incidence of blood staining, an indicator of direct trauma. However, postoperative throat pain is not increased [ 4 ]. We also assumed that by pre-warming the SLIPA, we would lower the incidence of blood staining and diminish the severity of throat pain as a result of the softening effect.…”

Scandinavian SSAI clinical practice guideline on pre‐hospital airway management

“…When clinical circumstances and provider competence allow, the SAD can be converted to a definitive tracheal tube reflecting the stepwise approach to airway management involving multiple techniques during a single resuscitation . Several second‐generation SAD models exist but evidence is inconclusive on the preferred model . The task force does not recommend any specific second‐generation model, but emphasises that EMS providers should be appropriately trained in inserting the specific device(s) in use by their service.…”

Evaluation of Head and Neck Position on Oropharyngeal Leak Pressure with Baska Mask and Streamlined Liner of Pharyngeal Airway (SLIPA<sup>TM</sup>): Arandomized Clinical Trial

“…Supraglottic airway devices (SGA) are used extensively during general anesthesia instead of tracheal intubation because of its less invasive nature [1]. The streamlined liner of the pharynx airway (SLIPA TM ) and the Baska mask are two of the latest addition to the Supraglottic airway devices.…”