The 3rd Generation Supraglottic Device The Baska Mask The 3rd Generation Supraglottic Device

Limitations of Existing Laryngeal Masks

Limitation No 1 The bowl of the LMA/ Proseal/ Fastrach/ Air Q is large and in 6-8% of patients it may incorporate the esophageal as well as glottic opening predisposing to aspiration of regurgitated material.

Solved by a smaller bowl of Baska Mask

Limitation No 2 Negotiation of oropharyngeal curve by existing LMA & its variant is at times difficult especially when the angle of the oropharynx is <900

Solved by a tab on the Baska Mask which can increase its angulation for easy negotiation of the oropharyngeal curve

Limitation No 3 When suction is applied to the gastric channel of the Proseal LM, usually nothing is sucked out as the opening gets impinged on the esophageal wall due to strong negative suction.

Solved in Baska mask by adding a second gastric channel which is left open to ambient atmosphere to nearly equilibrate the pressure in the sump cavity to atmospheric

Limitation No 4 The distal opening of the gastric channel is too small for suctioning any significantly sized particulate matter.

This problem is solved by enlarging the size of gastric channel opening and making it fish mouth type in Baska mask.

Limitation No 5 During the phase of emergence from anesthesia, if patient bites on the LMA shaft, there may be complete occlusion of the ventilatory shaft. Second reason of occlusion of ventilation is that the tongue impinges on the bowl of the partly pulled LMA/Proseal LM and occludes ventilatory passage.

In Baska mask, the two gastric channel will function as ventilatory channels if the main ventilatory channel gets occluded

Limitation No 6 All SGD with inflated cuff should ideally be inflated to <60 cmH2O using a cuff pressure inflator cum monitor or else it may compress the capillary vessels to levels of ischemia.

Baska mask is a cuffless device with a membranous bowl which inflates with each positive pressure and then deflates to atmospheric levels during passive expiration.

A Brief Description of the Baska Mask

Description of Baska Mask

Color coded connectors Baska Mask Sizes Size Color coded connectors 3 Green 4 Yellow 5 Red 6 Blue

Standard Placement/Removal Technique

Standard Placement Technique Lubricate the device well on both sides with water soluble jelly. Place the patient’s head and neck in neutral position. Wait for adequate depth of anesthesia.

Standard Placement Technique (Contd) Compress the proximal firmer part of the mask between the thumb and two fingers and advance the device towards the hard and soft palate.

Standard Placement Technique (Contd) Pull on the tab gently if needed to increase the device curvature to negotiate the palato-pharyngeal curve.

Standard Placement Technique (Contd) Advance till resistance is felt. In this position the distal tip of the device lies in the upper part of the esophagus.

Standard Placement Technique (Contd) If gastric regurgitation is expected, connect the suction elbow to a suction device to be used intermittently.

Removal of the Baska Mask Wait for the patient to wake up. Remove the restraining adhesives, ask the patient to open mouth. During device removal, keep the suction in continuous mode.