Comparison of the clinical performance of i-gel, LMA Supreme and LMA ProSeal in elective surgery

Abstract

INTRODUCTIONThe LMA Supreme™, i-gel ® and LMA ProSeal™ are second-generation supraglottic airway devices. We tested the hypothesis that these devices differ in performance when used for spontaneous ventilation during anaesthesia.METHODS 150 patients who underwent general anaesthesia for elective surgery were randomly allocated into three groups. Data was collected on oropharyngeal leak pressures, ease and duration of device insertion, ease of gastric tube insertion, and airway safety. RESULTSLeak pressure, our primary outcome measure, was found to be higher for the i-gel than the Supreme and ProSeal (mean ± standard error of the mean: 27.31 ± 0.92 cmH 2 O, 23.60 ± 0.70 cmH 2 O and 24.44 ± 0.70 cmH 2 O, respectively; p = 0.003). Devices were inserted on the first attempt for 90%, 82% and 72% of patients in the i-gel, Supreme and ProSeal groups, respectively (p = 0.105); mean device placement times were 23.58 seconds, 25.10 seconds and 26.34 seconds, respectively (p = 0.477). Gastric tubes were inserted on the first attempt in 100% of patients in the Supreme group, and 94% of patients in the i-gel and ProSeal groups (p = 0.100). There was blood staining on removal in 9 (18%) patients in each of the Supreme and ProSeal groups, with none in the i-gel group (p = 0.007). The incidence of postoperative sore throat, dysphagia and hoarseness was lowest for the i-gel. CONCLUSIONThe three devices were comparable in terms of ease and duration of placement, but the i-gel had higher initial oropharyngeal leak pressure and lower airway morbidity compared with the ProSeal and Supreme.

Comparison of I-Gel and Proseal Laryngeal Mask Airway for Airway Management in Adult Patients Undergoing Elective Surgeries in General Anaesthesia

“…The observations made in this study are in accordance with study results of Jindal P et al 14 As a complication, blood staining and tongue/lip/dental trauma was more in Group I, while none of the Group II patients had any and the difference was highly significant. Similar results were found for I-gel by Liew GHC et al 15 (p= 0.007) and Chauhan G et al 11 (p= 0.045). Singh I et al 16 conducted a study which showed that incidence of blood staining of the device was more with LMA-ProSeal (6/30) than with I-gel (1/30) and tongue, lip and dental trauma was more with LMA-ProSeal (5/30) than with I-gel (1 /30) which was otherwise statistically not significant.…”

A cohort evaluation of clinical use and performance characteristics of Ambu® AuraGain™: A prospective observational study

“…[ 7 14 ] Similar leak pressures have been reported previously suggesting that AG is as effective as other second-generation SGDs. [ 13 15 16 ]…”

A comparative evaluation of I-gel and laryngeal mask airway supreme in laparoscopic surgeries: a randomized comparative study

“…Teoh WHL et al, and Liew GHC et al, also found that longer time was required to insert the gastric tube in the I-gel group as compared to SLMA. 12,18 Park SY et al, also found longer insertion time for gastric tube in I-gel than SLMA but every gastric tube was successfully inserted on the first attempt in both groups in their study. 13 Regarding hemodynamics author have observed that there was less hemodynamic stress response with SLMA when compared with I gel, but difference was not statistically significant.…”

“…Liew GHC et al, found that the success rates of the first insertion attempt was higher for I-gel (90%) in comparison to SLMA (82%) which is in contrast to this study. 12,18 The mean device insertion time was longer with I-Gel (27.97±6.30 seconds) than with SLMA (13.80±2.85 seconds) (p=0.0001). Zundert V et al, and Fernandez et al, have also showed in their study that the SLMA was easier to insert and had a shorter effective airway time than the I-gel.…”