Use of supraglottic airway devices in children

Chung, Chan Jong

Review

Pediatric Anesthesia

Anesthesia and Pain Medicine 2014;9(1):1-8.
Published online January 30, 2014.

Use of supraglottic airway devices in children

Chan Jong Chung

Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan, Korea. cjchung@dau.ac.kr

Received: 8 October 2013

Abstract

Supraglottic airway devices (SADs) have become prevalent in children because they avoid many of the adverse effects associated with endotracheal intubation. The laryngeal mask airway (LMA) Classic and the LMA Proseal have proven safe and efficacious for routine cases in pediatric patients. The LMA Proseal provides a better airway seal and protection against aspiration than the LMA Classic in children. Most SADs are designed for airway maintenance during routine anesthesia, but other roles include rescue airway after failed intubation, conduit to facilitate difficult intubation and as an adjunct device for special situations in or outside the hospital (e.g., neonatal resuscitation). Recently developed second-generation SADs, the i-gel and the LMA Supreme may be a suitable alternative for airway management when a single-use device with gastric access is needed in children. The Air-Q intubating laryngeal airway may be feasible as a conduit for tracheal intubation for pediatric patients with a difficult airway. This review article discusses the safety and efficacy of SADs in children.

Key Words: Difficult airway, Laryngeal mask airway, Pediatric patient, Supraglottic airway device