Guided vs. non-guided insertion of Ambu AuraGain™ in edentulous patients.

Abstract

Supraglottic airway devices perform more poorly and have lower oropharyngeal leak pressure in edentulous patients than in patients with teeth. The Ambu Aura Gain is anewer second generation supraglottic airway device. This randomized clinical trial assessed the oropharyngeal leak pressure in edentulous patients using the Ambu Aura Gain with agastric tube for insertion guidance and without insertion guidance. Patients with ASA (American Society of Anesthesiology) physical status I-III were recruited. Primary outcome was oropharyngeal leak pressure after insertion. Secondary outcome parameters were oropharyngeal leak pressure15 min and 30 min after insertion, insertion time, insertion attempts and glottis view through flexible fiberscope. In this study 72patients aged between51 and90 years (mean73 years) were randomly allocated to the "with guidance" (n = 36) or the "without guidance" group (n = 36). Mean (SD) oropharyngeal leak pressure in "with guidance" and "without guidance" group was 24 cm H2O and 24 cm H2O (ns), respectively. Adifference was found in mean insertion time with guidance versus without guidance group52 s (45 s) vs.26 s (15 s) (p < 0.001). No difference was found in any of the other secondary outcome parameters. Aguided insertion technique does not improve oropharyngeal leak pressure of the Ambu AuraGain™ in edentulous patients. As the only difference is an increase in insertion time this technique is of no benefit for this population.