| Summary: | For many years there was arguably little progress at the frontline of airway management as all we had was our hands, then a classic laryngoscope and later, a classic laryngeal mask to control the airway. Since then, the airway armamentarium has progressed in quantum leaps, particularly with the introduction of videolaryngoscopy and a wide range of supraglottic airway devices (SADs). At present, SADs have collectively enjoyed an unparalleled safety record and are very popular devices in everyday practice with broadening indications. Of the globally ~250 million patients undergoing major surgery under general anaesthesia on an annual basis, some 60% receive such a device to maintain a patent airway. The vast majority of anaesthetics in patients undergoing elective surgery are performed using some form of SAD. Since the initial introduction of the LMA-Classic, the evolution in supraglottic airway designs has been a continuous process. Consequently, many new characteristics have been added in an attempt to combine efficacy with safety. Some of these changes were subtle, e.g. from re-usable to single use disposable or progression from classic to flexible SAD. Other changes genuinely added innovations in functions through design, e.g. facilitation of tracheal intubation, or of stomach decompression via an oesophageal vent.
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