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LETTER TO THE EDITOR

Esophageal Seal Is Not the Only Consideration in Supraglottic Airway Devices

Clinic of Anesthesiology and Critical Care Medicine; University Hospital Mannheim, Germany; harald.genzwuerker{at}anaes.ma.uni-heidelberg.de

To the Editor:

In their comparison of seven supraglottic airway devices, Bercker et al.1 conclude that the Combitube, Easytube, and intubating laryngeal mask Fastrach showed the best capacity to withstand an increase of esophageal pressure exceeding 100 cm H₂O in a cadaver model. Although the focus is on avoidance of aspiration, other aspects might be of greater importance.

Apart from the rather mechanistic idea of plugging a tube, separation of respiratory and alimentary tract with a supraglottic airway device aiming primarily at successful ventilation also includes considerations such as success rates, invasiveness, insertion time, training requirements, or availability of sizes for pediatric and adult patients.

As the authors cite a comparison of LMA-ProSeal and LTS for ventilation during elective laparoscopic gynecological interventions from our department2 mentioning that these devices "may be safely used ...despite the increased risk of aspiration," we would like to point out that failure to place a gastric tube was considered a reason for tracheal intubation in this trial.

REFERENCES

1. Bercker S, Schmidbauer W, Volk T, Bogusch G, Bubser HP, Hensel M, Kerner T. A comparison of seal in seven supraglottic airway devices using a cadaver model of elevated esophageal pressure. Anesth Analg 2008;106:445–8[Abstract/Free Full Text]
2. Roth H, Genzwuerker HV, Rothhaas A, Finteis T, Schmeck J. The ProSeal laryngeal mask airway and the laryngeal tube suction for ventilation in gynaecological patients undergoing laparoscopic surgery. Eur J Anaesthesiol 2005;22:117–22[Web of Science][Medline]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Genzwuerker, H. V. Articles by Hinkelbein, J. Search for Related Content PubMed PubMed Citation Articles by Genzwuerker, H. V. Articles by Hinkelbein, J.