Comparison of Oropharyngeal Leak Pressure of Air-Q™, I-gel™, and Laryngeal Mask Airway Supreme™ in Adult Patients During General Anesthesia: A Randomized Controlled Trial

Overview

Journal Saudi J Anaesth

Specialty Anesthesiology

Date 2017 Oct 17

PMID 29033717

Citations 7

Authors

Srinath Damodaran

Sameer Sethi

Surender Kumar Malhotra

Tanvir Samra

Souvik Maitra

Vikas Saini

Affiliations

Soon will be listed here.

Abstract

Study Objective: Various randomized controlled trials and a meta-analysis have compared i-gel™ and laryngeal mask airway Supreme™ (LMA-S™) in adult patients and found that both the devices provided equivalent oropharyngeal leak pressure (OLP). However, no randomized controlled trial has compared air-Q™ with i-gel™ and LMA-S™ in adult patient. Hence, we designed this study to compare air-Q™ with LMA-S™ and i-gel™ in adult patients.

Materials And Methods: A total of 75 adult patients of the American Society of Anesthesiologists physical status I/II of both sexes, between 18 and 60 years, were included in this prospective randomized controlled trial conducted in a tertiary care center. Randomization of patients was done in three equal groups according to the insertion of supraglottic airway device by a computer-generated random number sequence: group air-Q™ ( = 25), group i-gel™ ( = 25), and group LMA-S™ ( = 25). Primary outcome of this study was OLP. We also recorded time for successful placement of device, ease of device insertion, number of attempts to insert device, and ease of gastric tube insertion along with postoperative complications.

Results: The mean ± standard deviation OLP of air-Q™, i-gel™, and LMA-S™ was 26.13 ± 4.957 cm, 23.75 ± 5.439 cm, and 24.80 ± 4.78 cm HO ( = 0.279). The first insertion success rate for air-Q™, i-gel™, and LMA-S™ was 80%, 76%, and 92%, respectively ( = 0.353). The insertion time of air-Q™, i-gel™, and LMA-S™ was 20.6 ± 4.4, 14.8 ± 5.4, and 15.2 ± 4.7 s, respectively ( = 0.000). Time taken for air-Q™ insertion was significantly higher than time taken for i-gel™ (mean difference 5.8 s, < 0.0001) and LMA-S™ (mean difference 5.4 s, = 0.0001) insertion. Postoperative complications were similar with all three devices.

Conclusions: We concluded that air-Q™, i-gel™, and LMA-S™ were equally efficacious in terms of routine airway management in adult patients with normal airway anatomy.

Citing Articles

Choice of supraglottic airway devices: a network meta-analysis of randomised controlled trials.

Kanakaraj M, Bhat A, Singh N, Balasubramanian S, Tyagi A, Aathreya R Br J Anaesth. 2024; 133(6):1284-1306.

PMID: 39406569 PMC: 11589487. DOI: 10.1016/j.bja.2024.09.001.

Prospective Clinical Evaluation of the Singularity™ Air Laryngeal Mask in Adult Patients.

Martins J, Beutel B, Ettlin N, Nickel N, Wuthrich R, Sandoz R J Clin Med. 2023; 12(23).

PMID: 38068364 PMC: 10707142. DOI: 10.3390/jcm12237312.

Comparison of oropharyngeal leak pressure of I-gelTM and BlockbusterTM laryngeal mask airway in anaesthetized pediatric patients.

Selvin C, Singariya G, Bihani P, Kamal M, Paliwal N, Ujwal S Anesth Pain Med (Seoul). 2023; 18(1):51-56.

PMID: 36746902 PMC: 9902638. DOI: 10.17085/apm.22209.

Comparison of success rate of BlockBuster versus Fastrach LMA as conduit for blind endotracheal intubation: A prospective randomised trial.

Endigeri A, Ganeshnavar A, Varaprasad B, Shivanand Y, Ayyangouda B Indian J Anaesth. 2019; 63(12):988-994.

PMID: 31879422 PMC: 6921324. DOI: 10.4103/ija.IJA_396_19.

A left-side channel design improving insertion of gastric tube via the supraglottic airway device.

Ke J, Hou H, Wang M, Xue F Chin Med J (Engl). 2019; 132(11):1365-1367.

PMID: 30913067 PMC: 6629345. DOI: 10.1097/CM9.0000000000000222.

References

Galgon R, Schroeder K, Han S, Andrei A, Joffe A . The air-Q(®) intubating laryngeal airway vs the LMA-ProSeal(TM) : a prospective, randomised trial of airway seal pressure. Anaesthesia. 2011; 66(12):1093-100. PMC: 3358348. DOI: 10.1111/j.1365-2044.2011.06863.x. View

Benger J, Coates D, Davies S, Greenwood R, Nolan J, Rhys M . Randomised comparison of the effectiveness of the laryngeal mask airway supreme, i-gel and current practice in the initial airway management of out of hospital cardiac arrest: a feasibility study. Br J Anaesth. 2016; 116(2):262-8. DOI: 10.1093/bja/aev477. View

Cook T, Woodall N, Frerk C . Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth. 2011; 106(5):617-31. DOI: 10.1093/bja/aer058. View

Karim Y, Swanson D . Comparison of blind tracheal intubation through the intubating laryngeal mask airway (LMA Fastrach™) and the Air-Q™. Anaesthesia. 2011; 66(3):185-90. DOI: 10.1111/j.1365-2044.2011.06625.x. View

Ragazzi R, Finessi L, Farinelli I, Alvisi R, Volta C . LMA Supreme™ vs i-gel™--a comparison of insertion success in novices. Anaesthesia. 2012; 67(4):384-8. DOI: 10.1111/j.1365-2044.2011.07002.x. View

Park S, Rim J, Kim H, Lee J, Chung C . Comparison of i-gel® and LMA Supreme® during laparoscopic cholecystectomy. Korean J Anesthesiol. 2015; 68(5):455-61. PMC: 4610924. DOI: 10.4097/kjae.2015.68.5.455. View

Maitra S, Khanna P, Baidya D . Comparison of laryngeal mask airway Supreme and laryngeal mask airway Pro-Seal for controlled ventilation during general anaesthesia in adult patients: systematic review with meta-analysis. Eur J Anaesthesiol. 2013; 31(5):266-73. DOI: 10.1097/01.EJA.0000435015.89651.3d. View

Theiler L, Kleine-Brueggeney M, Kaiser D, Urwyler N, Luyet C, Vogt A . Crossover comparison of the laryngeal mask supreme and the i-gel in simulated difficult airway scenario in anesthetized patients. Anesthesiology. 2009; 111(1):55-62. DOI: 10.1097/ALN.0b013e3181a4c6b9. View

Bakker E, Valkenburg M, Galvin E . Pilot study of the air-Q intubating laryngeal airway in clinical use. Anaesth Intensive Care. 2010; 38(2):346-8. DOI: 10.1177/0310057X1003800217. View

10.

Cook T, Gatward J, Handel J, Hardy R, Thompson C, Srivastava R . Evaluation of the LMA Supreme in 100 non-paralysed patients. Anaesthesia. 2009; 64(5):555-62. DOI: 10.1111/j.1365-2044.2008.05824.x. View

11.

Henderson J, Popat M, Latto I, Pearce A . Difficult Airway Society guidelines for management of the unanticipated difficult intubation. Anaesthesia. 2004; 59(7):675-94. DOI: 10.1111/j.1365-2044.2004.03831.x. View

12.

Kleine-Brueggeney M, Nicolet A, Nabecker S, Seiler S, Stucki F, Greif R . Blind intubation of anaesthetised children with supraglottic airway devices AmbuAura-i and Air-Q cannot be recommended: A randomised controlled trial. Eur J Anaesthesiol. 2015; 32(9):631-9. DOI: 10.1097/EJA.0000000000000261. View

13.

Chew E, Hashim N, Wang C . Randomised comparison of the LMA Supreme with the I-Gel in spontaneously breathing anaesthetised adult patients. Anaesth Intensive Care. 2011; 38(6):1018-22. DOI: 10.1177/0310057X1003800609. View

14.

Jagannathan N, Sohn L, Ramsey M, Huang A, Sawardekar A, Sequera-Ramos L . A randomized comparison between the i-gel™ and the air-Q™ supraglottic airways when used by anesthesiology trainees as conduits for tracheal intubation in children. Can J Anaesth. 2014; 62(6):587-94. DOI: 10.1007/s12630-014-0304-9. View

15.

Chen X, Jiao J, Cong X, Liu L, Wu X . A comparison of the performance of the I-gel™ vs. the LMA-S™during anesthesia: a meta-analysis of randomized controlled trials. PLoS One. 2013; 8(8):e71910. PMC: 3741209. DOI: 10.1371/journal.pone.0071910. View

16.

Belena J, Nunez M, Vidal A, Gasco C, Alcojor A, Lee P . Randomized comparison of the i-gel(TM) with the LMA Supreme (TM) in anesthetized adult patients. Anaesthesist. 2015; 64(4):271-6. DOI: 10.1007/s00101-015-0020-z. View

17.

Keller C, Brimacombe J, Keller K, Morris R . Comparison of four methods for assessing airway sealing pressure with the laryngeal mask airway in adult patients. Br J Anaesth. 1999; 82(2):286-7. DOI: 10.1093/bja/82.2.286. View

18.

Joffe A, Liew E, Galgon R, Viernes D, Treggiari M . The second-generation air-Q intubating laryngeal mask for airway maintenance during anaesthesia in adults: a report of the first 70 uses. Anaesth Intensive Care. 2011; 39(1):40-5. DOI: 10.1177/0310057X1103900106. View

19.

Teoh W, Lee K, Suhitharan T, Yahaya Z, Teo M, Sia A . Comparison of the LMA Supreme vs the i-gel in paralysed patients undergoing gynaecological laparoscopic surgery with controlled ventilation. Anaesthesia. 2010; 65(12):1173-9. DOI: 10.1111/j.1365-2044.2010.06534.x. View

20.

Eschertzhuber S, Brimacombe J, Kaufmann M, Keller C, Tiefenthaler W . Directly measured mucosal pressures produced by the i-gel™ and Laryngeal Mask Airway Supreme™ in paralysed anaesthetised patients. Anaesthesia. 2012; 67(4):407-10. DOI: 10.1111/j.1365-2044.2011.07024.x. View