Direct comparison
LMA vs ETT: Laryngeal Mask vs Endotracheal Tube
LMA vs ETT compared: where each sits relative to the glottis, how FDA classifies them (Class I vs II), the Fastrach link, and one cesarean trial.
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How do LMA (laryngeal mask airway), ETT (endotracheal tube) compare side by side?
The table below compares LMA (laryngeal mask airway), ETT (endotracheal tube) across 10 procurement-relevant dimensions, from what it is through source.
Side-by-side comparison
| Dimension | LMA (laryngeal mask airway) | ETT (endotracheal tube) |
|---|---|---|
| What it is | An airway that incorporates a large cuff sitting above the glottic opening, with a standard 15 mm connector at the other end (FDA 510(k) K130304, LMA family). | A device inserted into the patient's trachea via the nose or mouth and used to maintain an open airway (21 CFR 868.5730). |
| Position relative to the glottis | Above the glottic opening (supraglottic). | Inside the trachea. |
| FDA regulation | 21 CFR 868.5110, oropharyngeal airway: inserted into the pharynx through the mouth to provide a patent airway. FDA product code CAE. | 21 CFR 868.5730, tracheal tube. FDA product code BTR (Tube, Tracheal, with or without connector). |
| FDA device class | Class I (general controls); the LMA family summary lists it as Class I exempt, and 868.5110 exempts it from premarket notification subject to the limitations in 868.9. | Class II (performance standards). A tracheal tube, the LMA Fastrach ETT SU (K242495), appears in the openFDA 510(k) database with a decision dated 2025-04-29. |
| Design variants named in FDA records | LMA ProSeal has a second lumen for drainage; a flexible version has a wire-reinforced shaft. | The LMA Fastrach ETT is described as a straight, cuffed, wire-reinforced tracheal tube designed for use with the LMA Fastrach. |
| Can they be used together? | Yes. The LMA Fastrach is indicated as a guide for intubation of the trachea, including in anticipated or unexpected difficult airways. | Yes. The Fastrach ETT is the tracheal tube designed for use with the LMA Fastrach. |
| What one trial found (cesarean section under general anesthesia) | Supreme LMA arm, 460 patients: first-attempt success similar to ETT (OR 1.00, 95% CI 0.25-4.02); time to effective ventilation shorter by 22.96 s (95% CI 22.21-23.71); no aspiration reported. The authors call it a possible alternative for a carefully selected low-risk obstetric population. | ETT arm, 460 patients: same first-attempt success; slower to effective ventilation in this trial. The trial describes endotracheal intubation as the standard of care in the obstetric airway. Results apply to that population only. |
| Guideline position cited in that trial | The DAS 2004 guideline incorporated the LMA as a second-line rescue device (obstetric patients excluded from that guideline). | Endotracheal intubation is described as the standard of care for the obstetric airway. |
| When each is the one named in the sources | Named as a second-line or rescue device in the guideline cited above, as a possible alternative in a selected low-risk group, and as a conduit for intubation (Fastrach). The choice for a given patient is a clinician's decision. | Named as the standard of care in the obstetric airway in the trial cited above, and as the tube used after a Fastrach-guided intubation. The choice for a given patient is a clinician's decision. |
| Source | FDA 510(k) summary K130304 (LMA family of airways, Teleflex, 30 May 2014), accessdata.fda.gov, read 2026-10-30; 21 CFR 868.5110 (law.cornell.edu, read 2026-10-30); openFDA device classification and 510(k) records, read 2026-10-30. | 21 CFR 868.5730 (law.cornell.edu, read 2026-10-30); openFDA product code BTR and 510(k) K242495, read 2026-10-30; BMC Anesthesiology 2019, PMC6615212, doi 10.1186/s12871-019-0792-9, read 2026-10-30. |
Common questions
Common questions about LMA (laryngeal mask airway) vs ETT (endotracheal tube)
Is an LMA the same as an endotracheal tube?
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No. An LMA is a supraglottic airway whose cuff sits above the glottic opening, regulated by FDA as an oropharyngeal airway (21 CFR 868.5110, Class I). An endotracheal tube is a tracheal tube inserted into the trachea (21 CFR 868.5730, Class II).
How does FDA classify an LMA and an ETT?
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FDA lists LMA-type airways under product code CAE, 21 CFR 868.5110, Class I, exempt from premarket notification subject to 868.9. Tracheal tubes are product code BTR, 21 CFR 868.5730, Class II. Source: 21 CFR and openFDA, read 2026-10-30.
Can an LMA be used to place an endotracheal tube?
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The LMA Fastrach is indicated by its manufacturer's FDA 510(k) summary (K130304) as a guide for intubation of the trachea, and has a dedicated wire-reinforced cuffed tracheal tube, the Fastrach ETT. This page does not describe the procedure; it is a clinician-performed technique.
Does an LMA take less time to ventilate than an ETT?
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In one randomized trial of 920 elective cesarean patients under general anesthesia, time to effective ventilation was shorter with the Supreme LMA by about 23 seconds, and first-attempt success was similar. The result applies to that population and does not generalize to other settings.
Going deeper
