A randomised comparison of the Ambu® AuraGain™ and the <scp>LMA</scp>® supreme in infants and children

Jagannathan, Narasimhan; Hajduk, John; Sohn, Lisa; Huang, Andrea; Sawardekar, Amod; Gebhardt, E. R.; Johnson, Kathleen N.; Oliveira, Gildàsio S. De

doi:10.1111/anae.13330

Cited by 42 publications

(89 citation statements)

References 23 publications

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“…[9] Another study reports similar OLP of AAU and LMA Supreme™ in children during controlled ventilation under general anaesthesia. [10] However, the OLP of AAU was comparable to that of other SGAs such as i-gel, PLMA and LMA Supreme™ as reported in some other studies. [81213] In our study, the OLP of both AAU and PLMA was higher than the peak airway pressure and was sufficient to prevent aspiration while ventilating the study patients during carboperitoneum.…”

Section: Discussionsupporting

confidence: 78%

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Comparative evaluation of Ambu AuraGain™ with ProSeal™ laryngeal mask airway in patients undergoing laparoscopic cholecystectomy

Singh

Gurha

2017

Indian J Anaesth

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Background and Aims:Second generation supraglottic airways are increasingly being used in surgical patients undergoing laparoscopic surgery. Preventing aspiration at higher airway pressures may be at the expense of a higher cuff pressure which can impair mucosal perfusion. We attempted to elucidate whether Ambu AuraGain™ (AAU) would provide a higher oropharyngeal leak pressure (OLP) with a lower mucosal pressure in comparison to ProSeal™ laryngeal mask airway (PLMA).Methods:This was a prospective randomised study involving sixty patients undergoing laparoscopic cholecystectomy under general anaesthesia, using either AAU (Group AAU [n = 30]) or PLMA (Group PLMA [n = 30]) for elective ventilation. Primary outcome measure was the OLP. Number of insertion attempts, ease of insertion, time required for placement and calculated pharyngeal mucosal pressure were the secondary outcome measures. Data were analysed using Student's t-test and Chi-square test.Results:No significant difference in the OLP was noted in both groups. The ease of insertion and success rate at first attempt was similar between the groups. Time taken for insertion in Group AAU was longer than Group PLMA (13.57 ± 1.94 vs. 11.60 ± 2.22 s). The calculated pharyngeal mucosal pressures were lower with Group AAU than Group PLMA for all 3 sizes. The minimum cuff pressure and minimum cuff volume required to prevent leak were found similar in both groups.Conclusion:AAU provides adequate sealing pressures and effective ventilation with lower calculated pharyngeal mucosal pressure, compared to PLMA.

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Section: Discussionsupporting

confidence: 78%

“…AAU has been compared to LMA supreme in a few studies,[91011] but to the best of our knowledge, there is no literature available that compares the clinical efficacy of AAU to PLMA in laparoscopic cholecystectomy. Hence, this study was undertaken to evaluate the safety profile of AAU in a clinical setting.…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of Ambu AuraGain™ with ProSeal™ laryngeal mask airway in patients undergoing laparoscopic cholecystectomy

Singh

Gurha

2017

Indian J Anaesth

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“…The full texts of 118 articles were examined in detail. We included 65 articles in this network meta‐analysis (Fig. ).…”

Section: Resultsmentioning

confidence: 99%

“…The trials had a median (range [IQR]) sample size of 60 (27–240 [53–100]). Sevoflurane was administered for anaesthesia induction in 44 studies . There were eight crossover designed studies .…”

Section: Resultsmentioning

confidence: 99%

A network meta‐analysis of the clinical properties of various types of supraglottic airway device in children

et al. 2017

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We conducted both conventional pairwise and Bayesian network meta-analyses to compare the clinical properties of supraglottic airway devices in children. We searched six databases for randomised clinical trials. Our primary end-points were oropharyngeal leak pressure, risk of insertion failure at first attempt, and blood staining risk. The risk of device failure, defined as the abandonment of the supraglottic airway device and replacement with a tracheal tube or another device, was also analysed. Sixty-five randomised clinical trials with 5823 participants were identified, involving 16 types of supraglottic airway device. Network meta-analysis showed that the i-gel™, Cobra perilaryngeal airway™ and Proseal laryngeal mask airway (LMA -Proseal) showed statistically significant differences in oropharyngeal leak pressure compared with the LMA -Classic, with mean differences (95% credible interval, CrI) of 3.6 (1.9-5.8), 4.6 (1.7-7.6) and 3.4 (2.0-4.8) cmH O, respectively. The i-gel was the only device that significantly reduced the risk of blood staining of the device compared with the LMA-Classic, with an odds ratio (95%CrI) of 0.46 (0.22-0.90). The risk (95%CI) of device failure with the LMA-Classic, LMA -Unique and LMA-Proseal was 0.36% (0.14-0.92%), 0.49% (0.13-1.8%) and 0.50% (0.23-1.1%), respectively, whereas the risk (95%CI) of the i-gel and PRO-Breathe was higher, at 3.4% (2.5-4.7%) and 6.0% (2.8-12.5%), respectively. The risk, expressed as odds ratio (95%CrI), of insertion failure at first attempt, was higher in patients weighing < 10 kg at 5.1 (1.6-20.1). We conclude that the LMA-Proseal may be the best supraglottic airway device for children as it has a high oropharyngeal leak pressure and a low risk of insertion. Although the i-gel has a high oropharyngeal leak pressure and low risk of blood staining of the device, the risk of device failure should be evaluated before its routine use can be recommended.

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“…In recent years, various studies have been done on device performance and insertion parameters for this device, [15,16,17] but no study has been reported so far comparing the effect of insertion or removal of Ambu AuraGain on IOP.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study on Intraocular Pressure Changes on Insertion of Endotracheal Tube, Ambu Auragain and I-Gel in Paediatric Patients in Non-Ocular Surgeries

Dwivedi¹,

Upadhyay²,

Kumar³

et al. 2017

jemds

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BACKGROUNDNewer supraglottic devices provide better perilaryngeal seal and cause lesser sympathetic stimulation and IOP changes, so they can be used as an alternative to conventional laryngoscopy and intubation.The aim of the study is to compare the changes in Intraocular Pressure (IOP) during and after insertion of endotracheal tube, Ambu AuraGain and I-gel in paediatric patients in non-ocular surgeries.

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A randomised comparison of the Ambu^® AuraGain^™ and the LMA^® supreme in infants and children

Cited by 42 publications

References 23 publications

Comparative evaluation of Ambu AuraGain™ with ProSeal™ laryngeal mask airway in patients undergoing laparoscopic cholecystectomy

Comparative evaluation of Ambu AuraGain™ with ProSeal™ laryngeal mask airway in patients undergoing laparoscopic cholecystectomy

A network meta‐analysis of the clinical properties of various types of supraglottic airway device in children

A Comparative Study on Intraocular Pressure Changes on Insertion of Endotracheal Tube, Ambu Auragain and I-Gel in Paediatric Patients in Non-Ocular Surgeries

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A randomised comparison of the Ambu® AuraGain™ and the LMA® supreme in infants and children

Cited by 42 publications

References 23 publications

Comparative evaluation of Ambu AuraGain™ with ProSeal™ laryngeal mask airway in patients undergoing laparoscopic cholecystectomy

Comparative evaluation of Ambu AuraGain™ with ProSeal™ laryngeal mask airway in patients undergoing laparoscopic cholecystectomy

A network meta‐analysis of the clinical properties of various types of supraglottic airway device in children

A Comparative Study on Intraocular Pressure Changes on Insertion of Endotracheal Tube, Ambu Auragain and I-Gel in Paediatric Patients in Non-Ocular Surgeries

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A randomised comparison of the Ambu^® AuraGain^™ and the LMA^® supreme in infants and children