Tracheal tube

The tracheal tube is more invasive. It protects the airway better than the cLMA once it is inserted, but not during insertion and removal.

Insertion and removal of a tracheal tube is associated with more complications than the cLMA.

Facemask

The facemask is only suitable for relatively short periods during uncomplicated anaesthetics. Maintenance of the airway with a facemask is a fundamental skill for anaesthetists. However, there is robust evidence that airway maintenance with a facemask is more difficult to do and less reliable than with the cLMA.

Overall, during anaesthesia an airway managed with the cLMA is likely to be better maintained and safer than one managed with a facemask.

Alternative supraglottic airway devices

The are many types of alternative supraglottic airway devices (SADs) including:

• Reinforced or flexible LMA (fLMA) have a wire-reinforced stem and are non-kinking. Suitable for nasal, oral, neck and shoulder surgery
• ProSeal LMA (PLMA) are designed to improve ventilation, reduce risk of aspiration and enable diagnosis of correct or malposition. Optimal LMA for controlled ventilation
• Supreme LMA is a single use PVC laryngeal mask, easily inserted, airway seal intermediate between cLMA and PLMA
• i-gel - single use cuffless airway of similar shape and design to inflated PLMA
• Laryngeal tube and laryngeal tube suction II are easily inserted SADs, but prone to obstruction due to axial rotation