Airway Management - Supraglottic Airway Devices

Cursul Na]ional de Ghiduri [i Protocoale în ATI As anesthesiologists we spend a respectable part of our career maintaining the airway. Theoretically, every anesthesiologist should be familiar with, and well practiced in a variety of the airway techniques that are available, so that when an airway problem occurs, it can be managed with a solid armamentarium of information and experience. However, with the rapid advancements in airway management technology, many of the newer airway devices are foreign to most anesthesiologists. In the last years a number of supraglottic airway devices have been introduced in the clinical practice of the airway management, trying to offer a simple and effective alternative to the endotracheal intubation. Supraglottic Airway Devices are devices that ventilate patients by delivering anesthetic gases/ oxygen above the level of the vocal cords and are designed to overcome the disadvantages of endotracheal ntubation as: soft tissue, tooth, vocal cords, laryngeal and tracheal damage, exaggerated hemodynamic response, barotrauma, etc. The advantages of the supraglottic airway devices include: avoidance of laryngoscopy, less invasive for the respiratory tract, better tolerated by patients, increased ease of placement, improved hemodynamic stability in emergence, less coughing, less sore throat, hands free airway and easier placement by inexperienced personal. The American Society of Anesthesiologists’ Task Force on Management of the Difficult Airway (1) suggests considering the use of the supraglottic airway devices (as Laryngeal Mask Airway and the Combitube) when intubation problems occur in patients with a previously unrecognized difficult airway, especially in a “cannot ventilate, cannot intubate” situation. The European Difficult Airway Society suggests using the Laryngeal Mask Airway or the Intubating Laryngeal Mask, in an unanticipated difficult tracheal intubation (2).