Supreme LMA and Endotracheal Intubation Use in Caesarean Section

Supreme LMA Versus Endotracheal Intubation in General Anaesthesia for Elective Caesarean Section- a Randomised Controlled Trial

The LMA Supreme (SLMA) is a single-use supraglottic device that provides a good seal for positive pressure ventilation and good first attempt insertion rate of 98% in low-risk patients undergoing Caesarean section. It has a double aperture design that facilitates the introduction of an orogastric tube to aspirate gastric contents. The current practice is to use endotracheal intubation with rapid sequence induction in general anaesthesia for Caesarean section.

The primary study hypothesis is the first attempt insertion success rate of SLMA and endotracheal intubation are equivalent with a difference of less than 3%.

We propose a randomised controlled trial to study the first attempt insertion success rate of supreme LMA versus endotracheal intubation in general anaesthesia for elective Caesarean section.

Inclusion Criteria:

• Age 18 to 50 years old
• ASA 1 or 2
• Fasted at least 6 hours
• Weight 40 to 75kg
• Normal airway assessment
• Singleton term pregnancy (>36weeks)
• Elective Caesarean section

Exclusion Criteria:

• In labour
• Body mass index >35
• Difficult airway (Mallampati 4 or abnormal airway assessment)
• Gastrooesophageal reflux disease