From Inception to Innovation: The Evolving Role of Supraglottic Airway Devices in Modern Anaesthesia Practice

Abstract Supraglottic airway devices (SADs) have transformed airway management since their introduction by Dr Archie Brain in the 1980s, evolving from simple ventilation aids to integral tools in modern anaesthetic practice and difficult airway management. Their design progression from first-generation devices such as the classic laryngeal mask airway to advanced second- and third-generation models with gastric drainage, higher sealing pressures and integrated visualisation and has expanded their safety and clinical profile. SADs now play a very critical role in difficult airway management, laparoscopic and obstetric procedures, interventional pulmonology and nonintubated video-assisted thoracic surgery in addition to routine anaesthesia practice. SADs have proven to be efficient in improving oxygenation and effective ventilation, minimising airway trauma, reducing haemodynamic stress, reducing postoperative complications and enhancing recovery. The integration of video-guided technology marks a significant advancement towards more precise airway management and safety. Thus, SADs represent a paradigm shift towards patient-centred, minimally invasive and physiology-preserving anaesthetic techniques.