Airway Rescue using the LMA Supreme™ in the prone position: a case report

Abstract

Surgery in prone positioning may pose considerable challenges to Anesthesiologists because of general accessibility to the patient; this is particularly true if referring to airway management, because the airway could be relatively inaccessible while the patient is lying prone.We report a case of an obese women scheduled for lower limbs surgery in the prone position in which the initial anesthetic choice for spinal anesthesia needed to be switched to general anesthesia during the procedure both for the occurrence of surgical complications and because the patient began to become uncooperative. We successfully managed this problem by inserting a LMA SupremeTM leaving the patient in the same prone position, and maintaining anesthesia in mechanical ventilation, thus allowing surgical procedure to be completed uneventfully. The possible options in similar cases and the specific features of LMA SupremeTM which allowed such a choice are discussed.