*7.3.5.2 Device description*

The parts of AuraGain are as follows (**Figures 12** and **13**):


polyvinylchloride, it is more flexible and less traumatic. Its fixed, anatomically curved shape is elliptical in cross section and aids easier insertion. It has two separate drain channels. At the machine end, they begin as the male and female suction ports. The channels then enter a chamber behind the cuff bowl. At the patient end, the chamber ends at the tip of the cuff. The device is flexible and stays in place if the patient's head is mobilised. A built-in bite block reduces the potential for damage to, or obstruction of the airway tube in the event of biting. Additionally, the LMA-Protector™ is available with a pilot balloon or the integrated Cuff Pilot™. The Cuff Pilot™ enables constant visualisation of intracuff pressure inside the mask cuff that provides easier adjustment and is colour coded for infla-

It is commercially available in size 3, 4 and 5. The manufacturer recommends using a size 4 device for normal adults. After insertion, the device is fixed in place and inflated to the recommended pressure. There should be a minimum of a 1 cm gap between the fixation tab and the patient's upper lip. The cuff should be inflated with sufficient air to prevent a leak with positive pressure ventilation, but it must not exceed either a pressure of 60 cm H2O or the specific device cuff volume maxima. If no manometer is available, inflate with just enough air to achieve a seal sufficient to permit ventilation without leaks. It provides high first attempt and overall insertion success rate. It helps rapidly achieve effective ventilation with reliable airway seal. Additionally, it acts as a conduit for FOB guided intubation

tion pressure [74].

**Figure 11.**

*LMA protector cuff pilot.*

[75, 76].

**264**

*7.3.4.2 Size selection, practical aspect, adjuncts*

*Special Considerations in Human Airway Management*

The mask is designed to conform to the contours of the hypopharynx with its lumen facing the laryngeal opening. When correctly inserted, the distal tip of the cuff rests against the upper oesophageal sphincter. It is anatomically shaped with an integrated bite block.
