Laryngeal tube S II, laryngeal tube S disposable, Fastrach laryngeal mask and Fastrach laryngeal mask disposable during elective surgery: a randomized controlled comparison between reusable and disposable supraglottic airway devices.

BACKGROUND AND OBJECTIVE: Analogue disposable devices of the laryngeal tube S II (LTS II) and the Fastrach laryngeal intubation mask (ILMA, Fastrach), namely the laryngeal tube disposable (LTS-D) and the Fastrach laryngeal intubation mask disposable (Fastrach-D), have recently been introduced. The purpose of this study was to compare each reusable device with the corresponding disposable one, during routine surgery.

METHODS: After informed consent, 120 American Society of Anesthesiologists I-III patients scheduled for routine minor surgery were randomly allocated to the LTS II (n = 30), the LTS-D (n = 30), the Fastrach (n = 30) and the Fastrach-D (n = 30) groups, respectively. Overall insertion success rates, time to first sufficient ventilation (V(e)t > or = 200 ml), resulting airway leak pressures (ALPs), subjective assessment of handling as well as patient comfort were determined.

RESULTS: Insertion success rates of the LTS II, LTS-D, Fastrach and Fastrach-D were 30/30, 29/30, 30/30 and 30/30, respectively. Time to successful insertion in the LTS II vs. the LTS-D group, as well as in the Fastrach vs. the Fastrach-D group, showed significant differences [median (min-max) s: 38 (13-187), 23 (9-108), P < 0,05; 27.5 (6-110), 16 (8-82), P < 0.05]. The highest ALP could be observed in the LTS-D group [median (min-max): 40 (16-40), P < 0.001 vs. all other devices] and the lowest ALP in the Fastrach-D group [median (min-max): 24.5 (12-40)]. ALP did not differ significantly in any group during variation of cuff volume by +/-20 ml. Subjective assessment of handling was significantly (P < 0.001) better in the LTS-D group than in the LTS II, Fastrach and Fastrach-D groups.

CONCLUSION: LTS II, LTS-D, Fastrach and Fastrach-D were all suitable for routine airway management. The LTS-D showed the best properties in terms of airway sealing and handling.