Supraglottic airways in children: past lessons, future directions.

摘要

The first prototype of the laryngeal mask airway (LMA™) was used clinically in the summer of 1981 at Ashford, Kent, UK, by Dr. Archie Brain. Dr. Brain followed in the worthy footsteps of Clover, O'Dwyer, Shipway, Leech, and others in developing a supraglottic airway to facilitate the delivery of anesthetic gases via a reliable supraglottic airway. The LMA~(tm) was released in the UK in 1988 and in the USA in 1992. Since the original range of pediatric LMAs~(tm)was soon found to be inadequate to address all children's sizes, half-sizes (1.5 and 2.5) were developed. As with adult practice, the LMA™ and other supraglottic airways have radically changed pediatric anesthesia practice and have become a key component of airway management in children, both in the operating room and in remote anesthesia locations. These devices have increasingly been advocated for emergency airway control in the field, in the emergency department, and in the delivery suite. So what have we learned about pediatric supraglottic airways over the past two decades and where does the future lie with respect to these devices?