Comparative Evaluation of Blockbuster™ and Fastrach™ Laryngeal Mask Airway for Endotracheal Intubation: A Prospective Randomised Study

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Background and Aim: The introduction of supraglottic airway devices (SADs) resulted in a paradigm shift in airway management. Fastrach™ intubating laryngeal mask airway (FT-LMA) is a SAD designed for blind endotracheal intubation. Blockbuster™ airway (BB) is a novel device intended for the same purpose and this study aims at comparing its efficacy with the FT-LMA. The aim was to compare success rates of endotracheal intubation, oropharyngeal leak pressure (OLP), fibreoptic grading of the laryngeal view, haemodynamic parameters and postoperative complications through BB and FT-LMA. Methods: One hundred consenting patients were randomly allocated into two groups of 50 each in a prospective randomised study. After induction, assigned SAD was inserted to obtain adequate ventilation. OLP and laryngeal grades were then noted. We then attempted blind intubation through the SAD with maximum of two attempts and the SAD was removed. Success at first attempt, time for tracheal intubation and effect on haemodynamic were noted. Results: Demographic data were comparable amongst the two groups. Both BB and FT-LMA were successfully placed within two attempts. The success rate of blind intubation was 100% in BB and 97% in FT-LMA. The OLP of BB was 28.3 versus 24.4 cm H2O in FT-LMA (P < 0.01). BB required less intubation time, lesser haemodynamic response and better OLP as compared between groups. However, the time taken for insertion of SAD, OLP and time taken for removal of SAD was significantly less with the BB. The fibreoptic grading was similar in both groups. Although the trachea was intubated through the device in all the patients (100%) in group BB, three patients (6%) were intubated in the second attempt in group FT-LMA with a first-attempt success rate of 94%. However, this difference is statistically insignificant. Conclusion: BB had higher OLP and is a better conduit for endotracheal intubation due to its quick insertion time and better haemodynamic in comparison with FT-LMA.