Videolaryngoscopic evaluation of hypopharyngeal lesions caused by PLMA and I-gel: A randomised controlled clinical trial

Abstract

ObjectiveThe ProSeal laryngeal mask airway (PLMA) and I-gel, both second-generation supraglottic airway devices have been compared in previous studies but with inconsistent results regarding their safety and efficacy. Their influence on the hypopharyngeal mucosa have not been evaluated before under videolaryngoscopy. MethodsOne hundred ASA I-II patients, aged 18–70 years who underwent elective surgery were randomly allocated for airway management with the I-gel or ProSeal laryngeal mask airway. Mucosal oedema, mucosal colour change and nodularity were evaluated with videolaryngoscopy. Insertion times, oropharyngeal leak pressure and complications were assessed. ResultsFor the ProSeal laryngeal mask airway, the mean insertion time (28 ± 15 vs. 18 ± 9.91, P < 0.001) and oropharyngeal leak pressure at the time of insertion (27 ± 7 vs. 23 ± 5, P = 0.01) were significantly higher than the I-gel. With the ProSeal laryngeal mask airway, the incidences of dysphagia were higher at 1 and 12 hours postoperatively (30% vs.12%, P = 0.024) and (16% vs. 4%, %, P = 0.046). A significant relationship was found between hypopharyngeal hyperemia and dysphagia (P = 0.001). ConclusionThe use of the I-gel resulted in fewer complications than the ProSeal laryngeal mask airway and seems to be advantageous over the ProSeal laryngeal mask airway in adults under general anaesthesia.