Insertion characteristics of three supraglottic airway devices: A randomized comparative trial

Abstract

Background I-gel is a new single-use supraglottic airway device without an inflatable cuff. The aim of this study was to compare I-gel, a Proseal laryngeal mask airway (PLMA), and a laryngeal tube (LT) for ease of insertion, hemodynamic effects of insertion, and associated airway morbidity. Patients and methods Seventy-five adult patients, both sexes, were assigned randomly to I-gel (I), PLMA (P), and LT (L) groups according to the supraglottic device applied. Insertion time, airway sealing pressure, insertion success rate, insertion-associated hemodynamic effects, ease of gastric tube insertion, and associated airway morbidities were assessed. Results Demographic data and duration of both surgery and anesthesia in the three groups were comparable. Insertion time (s) was significantly shorter in group I (18.9 ± 0.9) compared with group P (26.2 ± 1.1) and group L (26.2 ± 1.0). Airway sealing pressure (cm H 2 O) was higher in group P (29.6 ± 1.2) compared with group I (26.0 ± 1.0) and group L (22.9 ± 0.9). The success rate at the first insertion attempt was higher in group I (96.0%) compared with group P (84.0%) and group L (88%). Blood-stained devices and occurrence of postoperative sore throat were lower in group I than the P and L group, with no significant differences. Heart rate, mean arterial pressure, and cardiac index were significantly increased in the postinsertion period in the P and L group compared with group I. Conclusion In the I-gel group, higher insertion success rate, and lower both hemodynamic changes and airway morbidities were noted compared with PLMA and LT. However, airway sealing ability was better with PLMA.