Comparative study between LMA supreme with I-gel in anaesthetised adult patient on effectiveness and safety

Abstract

Background: Supreme laryngeal mask airway (SLMA) and I-gel airway devices are second generation supraglottic airway devices (SAD) and are good alternatives to intubation during surgeries. The study was conducted with the objective to compare two supraglottic airway devices for ease of insertion, number of attempts of insertion, hemodynamic changes, incidence of adverse effects like regurgitation, lip and dental trauma and post-operative sore throat, dysphagia or hoarseness. Methods: This study was conducted at Topiwala National Medical College and BYL Nair hospital, Mumbai. 80 patients of ASA class 1 and 2 with Mallampati grading 1 and 2, between age group of 18-60 years and with BMI <28kg/m 2 were selected for the study. After induction of anesthesia for all the patients, one of SAD (SLMA or I-gel) was inserted randomly and accordingly they are divided into two groups consisting of 40 in each. Insertion parameters, hemodynamic and respiratory parameters were noted. Patients were also observed for any complications for 1 hour and 24 hours postoperatively. Results: Both groups were compared in terms of demographic characteristics, insertion parameters, hemodynamic and respiratory parameters and found no statistically significant differences between them (p>0.05). Postoperatively no significant complications were observed in terms of dental injury, laryngospasm. Complication like sore throat after 1 hour and after 24 hours was comparatively more in I-gel group but difference was not significant at 1 hr (p>0.05). Dysphagia was reported more in SLMA group (8 cases) than I-gel group (1 case) at one hour and the difference was statistically significant (p=0.013). Conclusions: SLMA and I-GEL are better airway management option for patients undergoing short surgical procedures under general anaesthesia.Keywords: Efficacy, I-gel, Safety, Supraglottic airway devices, SLMA DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20175437Samel SA et al. Int J Res Med Sci. 2017 Dec;5(12):5263-5267 International Journal of Research in Medical Sciences | December 2017 | Vol 5 | Issue 12 Page 5264 seal pressure around the laryngeal opening. It has integral bite block and a tab for adhesive fixation of the device. Fixation tab is rectangular structure moulded on to the manifold at right angles and projects over the patient's upper lip. It is designed to facilitate easy insertion and fixation of the SLMA, after insertion and inflation of its cuff. 3 The I-gel is a truly unique latex free SAD. The shape, softness and contours accurately mirror the peri-laryngeal anatomy to create the perfect fit and no cuff inflation is required. I-Gel provides controlled ventilation and spontaneous breathing during anaesthesia and it allows easy recognition of gastric content and passage of drain tube and suctioning and venting. 4 Many studies have been conducted regarding the safety and efficacy of SLMA and I-gel in various situations. [4][5][6][7] But still there is a need to prove their safety and efficiency in short surgical procedures. Henc...

An audit of post-operative sore throat using different laryngeal mask airways

“…In our study, we found that the incidence and severity of POST for i-gel LMA were increased as compared to other forms of LMAs used. A contributing factor to this finding could potentially be the greater difficulty of insertion which could predispose to greater laryngopharyngeal trauma and thus sore throat, agreeing with current literature,[ 15 ] although some studies report the opposite: greater ease of insertion of the i-gel LMA. [ 16 ]…”