Complications with supraglottic airways: something to worry about or much ado about nothing?

T HE supraglottic airways have gained firm places in anesthetic practice since clinical introduction of the laryngeal mask airway (LMA) Classic (LMA North America, Inc., San Diego, CA) in 1988. Although they are generally being used safely, serious complications occasionally do occur during the use of the airways. To increase safety, we need to know the types, severity, and possible causative factors of complications, from studies of a large number of patients. In this issue of ANESTHESIOLOGY, Ramachandran et al. report a retrospective observational study, assessing the efficacy of the supraglottic airway (LMA Unique) in more than 15,000 patients, to find out possible risk factors of failure to use the device during anesthesia.