Comparison of Proseal LMA with i-Gel in children under controlled ventilation: a prospective randomised clinical study

Shiveshi, Praveen; Anandaswamy, Tejesh C

doi:10.1016/j.bjane.2021.02.042

Cited by 2 publications

(13 citation statements)

References 14 publications

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“…Then, 7 of 40 studies were excluded based on the exclusion criteria. Finally, a total of 33 studies were included in this meta-analysis [ 3 , 9 – 37 , 39 – 41 ]. Tables 1 and 2 show the features and methodological quality of RCTs, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…According to the pooled analysis of data from 30 trials [ 3 , 9 – 37 ], i-gel™ offered a considerably lower OLP than LMA ProSeal™ [MD = -1.53 (-2.89, -0.17), I 2 = 97%, P = 0.03] ( Fig 2 ). Upon certification by sensitivity analysis, the pooled result was not altered by a single research.…”

Section: Resultsmentioning

confidence: 99%

“…According to age subgroup exploration, the pooled outcomes displayed that i-gel™ offered a slightly greater OLP in the children subgroup, although an inadequate statistical difference was observed [MD = 1.34 (˗0.37, 3.04), I 2 = 95%, P = 0.12]; a lower OLP was recorded in the adult subgroup [MD = -3.48 (-5.62, -1.33), I 2 = 98%, P = 0.001] compared with LMA ProSeal™. Considering the potential use of NMB during anesthesia, the pooled results indicated that 15 trials [ 3 , 13 , 14 , 17 , 19 – 21 , 23 , 25 – 29 , 33 , 35 ] that applied NMB were covered, and the integrated outcome was lower for i-gel™ than for LMA ProSeal™ [MD = -2.74 (-4.92, -0.57), I 2 = 98%, P = 0.001]. Without NMB, the integrated outcome showed no considerable variation between the two groups [MD = -0.34 (˗2.31, 1.64), I 2 = 97%, P = 0.74].…”

Section: Resultsmentioning

confidence: 99%

“…Seven RCTs [ 9 – 15 ] observed higher OLP values in i-gel™ compared with LMA ProSeal™. However, 15 studies [ 16 – 30 ] recorded lower OLP values in i-gel™ compared with LMA ProSeal™, and 8 other research [ 3 , 31 – 37 ] found no difference. Therefore, RCTs alone cannot sufficiently offer adequate insights into the clinical applications of i-gel™ and LMA ProSeal™.…”

Section: Introductionmentioning

confidence: 98%

“…The common modality of airway administration in pediatric and adult patients for short surgical operations during general anesthesia is Supraglottic airway device (SAD) [ 1 , 2 ]. Sufficient ventilation, delivery of anesthetic agents and oxygenation are provided with low-risk respiratory adverse events , displacing the demand for traditional tracheal intubation [ 3 ]. The second-generation SADs with a gastric drain tube have been recommended to decrease the danger of reflux and aspiration of the first-generation tools [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Contrast of oropharyngeal leak pressure and clinical performance of I-gel™ and LMA ProSeal™ in patients: A meta-analysis

2022

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Background Conflicting outcomes have been reported for the i-gel™ and laryngeal mask airway (LMA) ProSeal™ in children and adults during general anesthesia. Randomized controlled trials (RCTs) that yielded wide contrast outcomes between i-gel™ and LMA ProSeal™ were included in this meta-analysis. Methods Two authors independently identified RCTs that compared i-gel™ with LMA ProSeal™ among patients receiving general anesthesia by performing searches in EMBASE, Cochrane, PubMed, and ScienceDirect. Discussion was adopted to resolve disagreements. Data were counted with Review Manger 5.3 and pooled by applying weighted mean difference (MD) and rlsk ratio (RR), and related 95% confidence intervals. Results A total of 33 RCTs with 2605 patients were included in the meta-analysis. I-gel™ provided a considerably lower oropharyngeal leak pressure [weighted average diversity (MD) = -1.53 (-2.89, -0.17), P = 0.03], incidence of blood staining on the supraglottic airway devices [RR = 0.44, (0.28, 0.69), P = 0.0003], sore throat [RR = 0.31 (0.18, 0.52), P<0.0001], and a short insertion time [MD = -5.61 (-7.71, -3.51), P<0.00001] than LMA ProSeal™. Compared with LMA ProSeal™, i-gel™ offered a significantly higher first-insertion success rate [RR = 1.03 (1.00, 1.06), P = 0.03] and ease of insertion [RR = 1.06 (1.01, 1.11), P = 0.03]. The gastric-tube-placement first insertion rate [RR = 1.04 (0.99, 1.10), P = 0.11], laryngospasm [RR = 0.76 (0.17, 3.31), P = 0.72], and cough [RR = 1.30 (0.49, 3.44), P = 0.60] between the two devices were similar. Conclusions Both devices could achieve a good seal to provide adequate ventilation. Compared with the used LMA ProSeal™, the i-gel™ was found to have fewer complications (blood stainning, sore throat) and offers certain advantages (short insertion time, higher first-insertion success rate and ease of insertion) in patients under general anesthesia.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Contrast of oropharyngeal leak pressure and clinical performance of I-gel™ and LMA ProSeal™ in patients: A meta-analysis

2022

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Comparison of Baska Mask Versus Proseal Laryngeal Mask Airway in Elective Surgeries Under General Anaesthesia: A Randomized Clinical Trial

Jose¹,

Kagalkar²,

Kattimani³

et al. 2023

Cureus

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BackgroundBaska Mask (BM) is a third-generation supraglottic airway device with a self-inflating cuff. This study aimed to evaluate the efficacy of the BM compared to ProSeal laryngeal mask airway (PLMA) regarding insertion time, ease of insertion, and oropharyngeal seal pressure in patients undergoing elective surgeries under general anesthesia for less than two hours. MethodsThis prospective, randomized, double-blind comparative study was done on 64 patients randomly divided into two groups, with 32 patients in the PLMA group (Group A) and 32 in the BM group (Group B). Individuals with a body mass index (BMI) of more than 30, a history of nausea/vomiting, or pharyngeal pathology were excluded from the trial. After induction with propofol 3-4 mg/kg, fentanyl 1-2 mcg/kg, and the neuromuscular blockade was achieved with atracurium 0.5 mg/kg, patients were inserted with either BM (n= 32) or PLMA (n= 32). The primary outcome measure was the time taken for insertion and ease of insertion. Secondary outcome measures included the number of attempts, oropharyngeal seal pressure (OSP), and laryngopharyngeal morbidity (trauma to lips, blood staining, and sore throat) immediately and 24 hours postoperatively. ResultsDemographic data were comparable and statistically insignificant. Regarding time and ease of insertion, the BM could be inserted in a lesser time of 24±1.136 seconds compared to PLMA which took 28.59±1.682 seconds, with a high success rate in the first attempt which was statistically significant. The BM provided a higher OSP (31.34 +1.638 cmH2O) when compared to PLMA (24.81±1.469 cmH2O) and was statistically significant. Complications associated with insertion trauma to the lip, blood staining, and sore throat were more in PLMA (15.6%, 15.6 %, 9.4%, respectively) compared to the BM (6.3%, 3.1%, 3.1%, respectively), and statistically insignificant. ConclusionBM had higher first-attempt successful insertion with better OSP compared to PLMA in patients under controlled ventilation.

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Comparison of Proseal LMA with i-Gel in children under controlled ventilation: a prospective randomised clinical study

Cited by 2 publications

References 14 publications

Contrast of oropharyngeal leak pressure and clinical performance of I-gel™ and LMA ProSeal™ in patients: A meta-analysis

Contrast of oropharyngeal leak pressure and clinical performance of I-gel™ and LMA ProSeal™ in patients: A meta-analysis

Comparison of Baska Mask Versus Proseal Laryngeal Mask Airway in Elective Surgeries Under General Anaesthesia: A Randomized Clinical Trial

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