Comparison of two different laryngeal mask models for airway management in patients with immobilization of the cervical spine

Background. Reduced cervical spine mobility can impair laryngoscopy and tracheal intubation. Supraglottic airway devices can be important alternatives for oxygenation under these circumstances. The Ambu laryngeal mask (ALM) and the LMA-Classic (LMA) are compared in patients with immobilization of the cervical spine. Methods. In 60 patients scheduled for elective ambulatory interventions, ALM or LMA were inserted after cervical immobilization with an extrication collar and assessment of laryngoscopic view. Insertion time (removal of facemask until first tidal volume), number of insertion attempts, airway leak pressure (cuff pressure 60 cm H2O), intraoperative complications and postoperative complaints were assessed. Results. Demographical data, insertion attempts, insertion time (ALM 15.6 +/- 4.4 s, LMA 15.5 +/- 4.9 s) and airway leak pressure (ALM 25.6 +/- 5.2 cm H2O, LMA 26.5 +/- 6.5 cm H2O) were comparable. Traces of blood were found in 6 LMAs and 3 ALMs after removal, mild trouble with swallowing (visual analogue scale, VAS 2-4) in the recovery room and after 24 h were complaints by 1 ALM and 2 LMA patients. Conclusions. LMA-Classic and Ambu laryngeal masks are suitable for rapid and reliable airway management in patients with cervical immobilization.