AUTHOR=Geng Zhiyu , Li Chunqing , Kong Hao , Song Linlin 

TITLE=Supreme laryngeal mask airway for cesarean section under general anesthesia: a 10-year retrospective cohort study

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1181503

DOI=10.3389/fmed.2023.1181503

ISSN=2296-858X

ABSTRACT=Background: Previous research showed the use of supraglottic airway in obstetric anesthesia. The relevant evidence of laryngeal mask airway (LMA) on maternal and neonatal outcomes is still limited. We aimed to assess the maternal and neonatal outcomes when the LMA Supreme was used for cesarean section under general anesthesia.
Methods: We included all patients underwent general anesthesia for cesarean section between January 2010 and December 2019. Propensity score matching was used to reduce potential bias from nonrandom selection of airway intervention. The primary outcome was adverse maternal and neonatal outcomes defined as maternal regurgitation, aspiration, hypoxemia, and low neonatal Apgar scores. Secondary outcomes included patient admission to the intensive care unit, neonate required tracheal intubation, external cardiac massage, and admission to the neonatal intensive care unit. 
Results: A total of 723 patients were included in the analysis, of whom 221 received Supreme laryngeal mask (LMA group) and 502 intubated with endotracheal tube (ETT group). After propensity score matching, 189 patients remained in each group. No episode of regurgitation and aspiration occurred in both groups. There was no difference in the rates of Apgar score below 7 at 1-min (14.3% LMA group vs. 15.3% ETT group, OR 0.931, 95% CI 0.574 to 1.510, P = 0.772) and 5-min (3.7% vs. 4.2%, OR 0.875, 95% CI 0.324 to 2.365, P = 0.792). No difference was observed in the secondary outcomes between the two groups.
Conclusions: The LMA Supreme was not associated with adverse maternal and neonatal outcomes when used for cesarean section under general anesthesia. It might be considered as an alternative to tracheal intubation in obstetric practice.