Laryngeal Mask Airway Supreme™ vs. the Spritztube® tracheal cannula in anaesthetised adult patients: A randomised controlled trial.

De Rosa, Silvia; Messina, Antonio; Sorbello, Massimiliano; Rigobello, Alessandro; Colombo, Davide; Piccolo, Anna; Bonaldi, Efrem; Gennaro, Paolo; Urukalo, Violeta; Pellizzari, Adriano; Bonato, Raffaele; Carboni, Stefano Checcacci

BACKGROUND The Spritztube is a new supraglottic airway device combining the ability to allow extraglottic ventilation of the lungs with the opportunity to perform fibreoptic-assisted intubation. OBJECTIVES To compare the Spritztube tracheal cannula with the Laryngeal Mask Airway Supreme (LMA-S) in anaesthetised adult patients. DESIGN A single-centre, randomised controlled study. SETTING Tertiary hospital. PATIENTS Mechanically ventilated patients undergoing elective surgery in the supine position under general anaesthesia were included. Main exclusion criteria were a history of, or predicted, difficult airway management according to SIAARTI guidelines and absence of written informed consent. INTERVENTIONS Patients received the LMA-S or Spritztube tracheal cannula to facilitate ventilation of the lungs. MAIN OUTCOME MEASURES Successful placement (primary outcome), time required for insertion, number of attempts, subjective assessment of ease of insertion, safety and incidence of complications were recorded. RESULTS One hundred and sixty seven patients were allocated to the LMA-S or Spritztube group, respectively, a total of 334 patients. In the LMA-S group, the device insertion failed in nine patients, compared with none in the Spritztube group (P = 0.002). Spritztube insertion was easy in 100% of cases compared with 94.6% of the cases in the LMA-S group (P = 0.03). The number of attempts was significantly higher with the LMA-S compared with the Spritztube (P = 0.0007), whereas the insertion times were comparable (P = 0.06). Except for the incidence of blood-staining, which was higher in the LMA-S group (P = 0.01), the number of complications was comparable in the two groups. CONCLUSION The Spritztube was as effective as the LMA-S in maintaining the airway with all patients being successfully ventilated without difficulty. The success rate of achieving a patent airway was comparable between the groups, with a similar occurrence of complications. TRIAL REGISTRATION NCT03443219.