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Advances in Supraglottic Airway. Dr. K. Sudarshan Consultant Anaesthetist Coimbatore. Which ones qualify ?. Should satisfy the following conditions. 1. Placed above the vocal cord level 2. Those devices which allow hands-free maintenance of an open airway

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advances in supraglottic airway

Advances in SupraglotticAirway

Dr. K. Sudarshan

Consultant Anaesthetist

Coimbatore

which ones qualify
Which ones qualify ?

Should satisfy the following conditions

slide3
1. Placed above the vocal cord level

2. Those devices which allow hands-free

maintenance of an open airway

3. Allows spontaneous or assisted

ventilation

1908 to date
1908 to date
  • 1908- Hewitt Airway
  • 1913- Connell
  • 1915- Lumbard
  • 1916 – Mona Roberts
  • 1923 - Phillips
  • 1924 – Poe
  • 1930 – Waters insufflation
  • 1933 – Guedel
  • 1957- Fink vallecular
  • 1957 – Safar Airway
  • 1977 – Berman intubating
  • 1982 – Patil Syracuse
  • 1983 – Laryngeal Mask – Archie brain
  • 1985 – Combitube
sir frederic william hewitt 1856 1916
Sir Frederic William Hewitt 1856 - 1916

A modified version of the original Hewitt airway

The original

Hewitt airway as it

appeared in the

February 15, 1908

issue of The Lancet.

slide9

COPA

COMBITUBE

NASOPHARYNGEAL AIRWAY

advancements
Advancements
  • New generation LMA’s
  • I gel
  • Laryngeal Tube/ King LTS/ LTD
  • Cobra plus tube
generally demonstrate
Generally demonstrate
  • Ability to be placed without direct visualization
  • Better cardio vascular stability both during insertion and removal
  • Minimal IOP and ICP changes
  • Provide little protection against aspiration
  • Contraindicated in full stomach patients
proseal lma supreme
Has two separate tubes

Three dimensional inflation of cuff

Holds a better cuff seal pressure

Proseal & LMA Supreme
flexible ambu lma
Flexometallic tube

Preformed angle

Better placement

Less incidence of dislodgement once placed

More useful in head and neck surgery

Flexible & Ambu LMA
ilma lma c trach
Allows intubation with minimal head and neck manipulation

Recommended in both difficult airway and Resuscitation algorithm

C Trach allows intubation under direct vision

ILMA & LMA C Trach
slide16
Single use, cuffless

Integral gastric channel

Epiglottic blocking ridge

Moulding feature

insertion technique
Insertion Technique

I GEL INSERTION

http://www.youtube.com/watch?v=8jqHCnThf1E

I GEL insertion in Lateral position

http://www.youtube.com/watch?v=uLtSojaSX6c

insertion steps
Use lateral approach

Introduce the tip into corner of mouth

Advance behind the base of tongue

Without exercising excessive force, advance until the base of the connector is aligned with teeth.

Inflate the cuff

INSERTION STEPS
laryngeal tube insetion
Laryngeal tube Insetion.
  • http://www.youtube.com/watch?v=cBpU_fJe6ZA
cobra plus tube
Distal end has softened openings

Used for both spontaneous and controlled ventilation

Serves as a rescue airway

Cobra plus tube
streamlined liner of pharyngeal airway silpa
Cuffless

Lines the pharynx

Large internal volume –Allows collection of secretion, minimize aspiration

Streamlined liner of Pharyngeal airway - SILPA
summary
Summary
  • Provides hands free maintenance of airway
  • Can be used for both spontaneous and controlled ventilation
  • Provide little protection against aspiration
  • Useful in
      • Routine anaesthesia
      • emergency airway management
      • Aid to intubation
thank you
THANK YOU

doctorsudarshan@gmail.com