In 1937, Canadian anesthesiologist Beverley Leech, M.D. (1898 to 1960), patented an early precursor to the laryngeal mask airway (LMA, lower left). His “pharyngeal bulb gasway,” also called the Leech airway, featured a soft, detachable rubber bulb around a tough metal core (upper left). Leech’s love for cyclopropane (right), dubbed the “champagne” of volatile anesthetics, inspired the airway’s design. Although rapid and smooth in onset, cyclopropane was expensive and explosive, mandating closed-circuit delivery. However, leak-free ventilation was challenging to achieve, as endotracheal intubation had yet to become routine. Laryngoscopes and tubes were still being refined, and prolonged laryngospasm easily occurred pre-curare. To avoid the risk of intubation, Leech envisioned a supraglottic airway that would optimize cyclopropane delivery through a closed circuit. For more than a year, he painstakingly examined the wax casts of cadaver throats to design a malleable bulb that conformed to the average adult pharynx. Once manufactured, the Leech airway gained favor. Its bulb, lubricated with Vaseline, could be advanced gently into the oropharynx of a mask-induced patient. However, when succinylcholine arrived in 1952, wondrously facilitating tracheal intubation, the Leech airway became obsolete. (Copyright © the American Society of Anesthesiologists’ Wood Library-Museum of Anesthesiology. www.woodlibrarymuseum.org)

In 1937, Canadian anesthesiologist Beverley Leech, M.D. (1898 to 1960), patented an early precursor to the laryngeal mask airway (LMA, lower left). His “pharyngeal bulb gasway,” also called the Leech airway, featured a soft, detachable rubber bulb around a tough metal core (upper left). Leech’s love for cyclopropane (right), dubbed the “champagne” of volatile anesthetics, inspired the airway’s design. Although rapid and smooth in onset, cyclopropane was expensive and explosive, mandating closed-circuit delivery. However, leak-free ventilation was challenging to achieve, as endotracheal intubation had yet to become routine. Laryngoscopes and tubes were still being refined, and prolonged laryngospasm easily occurred pre-curare. To avoid the risk of intubation, Leech envisioned a supraglottic airway that would optimize cyclopropane delivery through a closed circuit. For more than a year, he painstakingly examined the wax casts of cadaver throats to design a malleable bulb that conformed to the average adult pharynx. Once manufactured, the Leech airway gained favor. Its bulb, lubricated with Vaseline, could be advanced gently into the oropharynx of a mask-induced patient. However, when succinylcholine arrived in 1952, wondrously facilitating tracheal intubation, the Leech airway became obsolete. (Copyright © the American Society of Anesthesiologists’ Wood Library-Museum of Anesthesiology. www.woodlibrarymuseum.org)

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Jane S. Moon, M.D., Assistant Clinical Professor, Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, California.