Use of supraglottic airway devices in patients positioned other than supine

SummaryThe use of supraglottic airway devices (SAD) in non-conventional patient positions raises some concerns, particularly in the prone position. The purpose of this review was to evaluate the reported uses of SAD in patients in prone position for elective airway management, airway rescue after accidental extubation or airway management for emergent procedures. We found 8 retrospective case series and 6 prospective studies, which involved more than 1600 patients electively managed with laryngeal mask airways. The overall insertion and ventilation success rate was high and the reported adverse events were effectively corrected. Eight case reports describing the successful use of LMA in critical situations were also retrieved. No severe complication was documented. Based on the available data and current airway management evidence, recommendations for safe use in this context are suggested.