Abstract
Background and ObjectiveConflicting results were found between the I-gel™ and the LMA-Supreme™ during anesthesia, so we conducted a meta-analysis of randomized controlled trials (RCTs) to compare the effectiveness and safety of the I-gel™ vs. the LMA-Supreme™during anesthesia.MethodsA comprehensive search was conducted using Pubmed, EMbase, ISI Web of Knowledge, the Cochrane Library, China Journal Full-text Database, Chinese Biomedical Database, Chinese Scientific Journals Full-text Database, CMA Digital Periodicals, and Google scholar to find RCTs that compare the LMA-S™ with the i-gel™during anesthesia. Two reviewers independently selected trials, extracted data, and assessed the methodological qualities and evidence levels. Data were analyzed by RevMan 5.0 and comprehensive meta-analysis software.ResultsTen RCTs were included. There were no significant differences in oropharyngeal leak pressures (mean difference [MD] 0.72, 95% confidence interval [CI] –1.10 2.53), device placement time (MD –1.3, 95%CI –4.07 1.44), first attempt insertion success (risk ratio [RR] 1.01, 95% CI 0.9 1.14), grade 3 and 4 fiberoptic view (RR 0.89, 95%CI 0.65 1.21), and blood on removal (RR 0.62, 95%CI 0.32 1.22) between the i-gel™ and the LMA-Supreme™, respectively. However, the LMA-Supreme™was associated with easier gastric tube insertion (RR 1.17, 95%CI 1.07 1.29), and more sore throat (RR 2.56, 95%CI 1.60 4.12) than the i-gel™ group.ConclusionsThe LMA-Supreme™ and i-gel™ were similarly successful and rapidly inserted. However, the LMA-Supreme™ was shown to be easier for gastric tube insertion and associated with more sore throat compared with the i-gel™.
Highlights
Since the introduction of the classic laryngeal mask airway, the field of supraglottic airway devices (SGA) has experienced a remarkable evolution and SGA are routinely used in clinical anaesthesia [1]
The i-gelTMcomprises a soft, gel-like, non-inflatable cuff made of thermoplastic elastomer, a widened, flattened stem with a rigid bite-block that acts as a buccal stabilizer to reduce axial rotation and malpositioning, and an oesophageal vent through which a gastric tube can be passed [2,3,4]
Whereas the LMA SupremeTM is an inflatable device with an oesophageal drainage tube for suctioning gastric contents, with similar characteristics to the igelTM: presence of a drain tube to separate the gastrointestinal tract from the respiratory tract and built-in bite block [4,5,6]
Summary
Since the introduction of the classic laryngeal mask airway, the field of supraglottic airway devices (SGA) has experienced a remarkable evolution and SGA are routinely used in clinical anaesthesia [1]. Whereas the LMA SupremeTM is an inflatable device with an oesophageal drainage tube for suctioning gastric contents, with similar characteristics to the igelTM: presence of a drain tube to separate the gastrointestinal tract from the respiratory tract and built-in bite block [4,5,6]. It differs from the i-gelTM in the following aspects: it is constructed of medical grade silicone, and has an inflatable cuff, a reinforced tip, and an elliptical, anatomically shaped, semi-rigid airway tube [4]. Conflicting results were found between the I-gelTM and the LMA-SupremeTM during anesthesia, so we conducted a meta-analysis of randomized controlled trials (RCTs) to compare the effectiveness and safety of the IgelTM vs. the LMA-SupremeTMduring anesthesia
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