English

Abstract

BACKGROUND A wide array of supraglottic airway devices (SAD) are available for the present day anaesthetic practice, each having its own unique features. Laparoscopic surgeries demand meticulous airway maintenance due to the impact of pneumoperitoneum on cardiorespiratory physiology. It thus becomes imperative to have knowledge about the most optimal SAD that can be used for laparoscopic surgeries to provide good quality anaesthesia. The objective of this randomised trial was to compare the airway sealing pressure (ASP) of Baska mask and i-gel and overall success rate in patients undergoing laparoscopic surgeries under general anaesthesia and controlled ventilation. METHODS One hundred and forty patients undergoing laparoscopic surgeries were randomly assigned to either Baska group (Group B) or i-gel group (Group I). Anaesthesia was induced with propofol 2 - 2.5 milligram per kilogram (mg / kg) and relaxation achieved with vecuronium 0.1 mg / kg and SAD was inserted. The primary outcome was airway sealing pressure (ASP) noted after insertion of the device. The secondary outcome measures included the number of attempts and time taken for successful insertion, ASP after gas insufflation of abdomen, Brimacombe grading, hemodynamic changes, airway morbidity (blood on the SAD upon removal, post-operative sore throat, dysphagia and dysphonia) and any other adverse events associated with the use of the devices. RESULTS There were no significant differences in demographic and hemodynamic data. ASP after insertion of the device was significantly higher (p < 0.0001) with Baska than i-gel (41.45 + 4.72 versus 30.29 + 5.76 cm H2O respectively). Brimacombe scoring of grade four was seen in 75.3 % of Baska compared to 18 % in i-gel group. Time taken to insert Baska was significantly more than with i-gel (14.84 versus 11.25 seconds respectively, P < 0.001). However, first time success was more with Baska than with i-gel (147 versus 140 respectively). CONCLUSIONS Both Baska and i-gel can be used safely and effectively in laparoscopic surgeries. Baska provides a better ASP and Brimacombe view than i-gel. However, i-gel offers the advantage of easier insertion in shorter time. KEYWORDS Supraglottic Airway Device, Baska Mask, i-gel, Airway Sealing Pressure