Tongue numbness following laryngeal mask airway <scp>S</scp>upreme™ and i‐gel™ insertion: two case reports

Aim and Objectives: The present study was undertaken to compare the LMA Classic with LMA Supreme in assessing the ease of insertion, number of attempts, time for insertion, any unwanted responses, stability of device, peak airway pressure, leak volume and leak fraction and postoperative complications. Methods: A total of 274 patients of ASA grade 1 and 2 were included in the study and divided into two groups with 137 patients in each group: the LMA Classic group (group C) and LMA Supreme group (group S). All patients were induced with propofol 2.5 mg/kg and atracurium 0.5 mg/kg after that appropriate sized supraglottic airway device was inserted. The ease of insertion, number of attempts, duration of insertion, stability of device, peak airway pressure, leak volume and leak fraction and postoperative complications were recorded. Results: The insertion of Supreme LMA was very easy in 134 patients and was easy in 3 patients, difficult in 0 patients while the insertion of Classic LMA was very easy in 122 patients, easy in 15 patients and difficult in 0 patients. The first attempt insertion rate was more with Supreme LMA as compared to Classic LMA. The mean duration of insertion was significantly lower with Supreme LMA than with Classic LMA. The mean airway pressure was similar in both groups. Both devices were stable. Leak volume and Leak fraction was significantly higher in Classic LMA than Supreme LMA. Peri-operative complications were not significantly different between Supreme LMA and Classic LMA. Conclusions: The LMA Supreme is superior to the LMA Classic because of its ease of insertion with lesser leak volume and leak fraction and better first attempt insertion rate.

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“…This finding was compare with different studies [10,21,22]. The herniation of the LMA cuff could contribute to the higher peak pressures in LMA.…”

Section: Discussionsupporting

confidence: 76%

Comparative Study of laryngeal mask airway Supreme and laryngeal mask airway Classic in paralyzed patients

Chavan¹,

Budhakar²,

Agaskar³

2016

Int J of Biomed & Adv Res

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“…This disposable device has a curved rigid stem copying the upper airway anatomy and allowing easy insertion and PVC cuff resistant to gas diffusion. As far as we know, neural damage associated with the LMA Supreme is extremely rare and only two cases of lingual nerve injury have been reported to date [11, 12]. We believe our report is the first case of unilateral hypoglossal nerve injury associated with LMA Supreme.…”

Section: Discussionmentioning

confidence: 67%

Unilateral Hypoglossal Nerve Palsy after Use of the Laryngeal Mask Airway Supreme

Takahoko

Iwasaki

Sasakawa

et al. 2014

Case Reports in Anesthesiology

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Purpose. Hypoglossal nerve palsy after use of the laryngeal mask airway (LMA) is an exceptionally rare complication. We present the first case of unilateral hypoglossal nerve palsy after use of the LMA Supreme. Clinical Features. A healthy 67-year-old female was scheduled for a hallux valgus correction under general anesthesia combined with femoral and sciatic nerve blocks. A size 4 LMA Supreme was inserted successfully at the first attempt and the cuff was inflated with air at an intracuff pressure of 60 cmH2O using cuff pressure gauge. Anesthesia was maintained with oxygen, nitrous oxide (67%), and sevoflurane under spontaneous breathing. The surgery was uneventful and the duration of anesthesia was two hours. The LMA was removed as the patient woke and there were no immediate postoperative complications. The next morning, the patient complained of dysarthria and dysphasia. These symptoms were considered to be caused by the LMA compressing the nerve against the hyoid bone. Conservative treatment was chosen and the paralysis recovered completely after 5 months. Conclusion. Hypoglossal nerve injury may occur despite correct positioning of the LMA under the appropriate intracuff pressure. A follow-up period of at least 6 months should be taken into account for the recovery.

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“…The numbness resolved spontaneously by the 2-week follow-up examination. On the basis of this case as well as previous reports, it may be considered that lingual nerve palsy can occur even with the use of a non-inflatable cuff [2,3]. These reports suggest that the…”

Section: To the Editormentioning

confidence: 59%

Lingual nerve palsy after i-gel® use

Ueshima

Okumura

2016

J Anesth

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Tongue numbness following laryngeal mask airway Supreme™ and i‐gel™ insertion: two case reports

Cited by 22 publications

References 9 publications

Comparative Study of laryngeal mask airway Supreme and laryngeal mask airway Classic in paralyzed patients

Comparative Study of laryngeal mask airway Supreme and laryngeal mask airway Classic in paralyzed patients

Unilateral Hypoglossal Nerve Palsy after Use of the Laryngeal Mask Airway Supreme

Lingual nerve palsy after i-gel® use

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