The Three Supraglottic Airway Devices in Anesthetized Spontaneously Ventilated Patients.

Abstract

Background and Objective : The laryngeal mask airway (LMA) is a supraglottic airway device which is a good alternative to the bag-valve-mask ventilation device. LMA comes in several types. This study was designed to investigate the usefulness of the three types of LMA: classic laryngeal mask airway(cLMA), Proseal laryngeal mask airway(pLMA)  and I-gel in anesthetized spontaneously ventilated patients when performing different non-emergency surgical procedures.

Materials and Methods : This prospective, randomized study was conducted in 90 of ASA 1-3 patients who underwent different surgical procedures under general anesthesia with spontaneous ventilation. The patients were equally randomized into 3 groups; cLMA, pLMA and I-gel group. In all cases, the use of the three devices was inserted by an experienced anesthesiologist. In each case, insertion time and number of attempts were recorded. After successful insertion, the airway leak pressure was measured. Postoperative complications were assessed in PACU.

Results : There were no differences in the demographic data among the three groups. The success rates for first attempt of the insertion were similar among the three groups (p=0.186). The mean insertion time for the I-gel group (17.97 + 3.74 sec) was significantly lower than that of the pLMA group (26.10 + 6.45 sec) and the cLMA group(24.13 + 5.26 sec) (p< 0.001). The mean airway leak pressure of the pLMA group (27.70+3.30 cmH₂O) was significantly higher than that of I-gel group (23.23+3.22 cmH₂O) and cLMA group (20.60+3.40 cmH₂O) (p< 0.001). There were no differences in the incidence of adverse events among the three groups.

Conclusion : Insertion of I-gel was significantly more rapid than insertion of pLMA and cLMA. Airway leak pressure was significantly higher with pLMA than I-gel and cLMA.