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Korean J Anesthesiol > Epub ahead of print
DOI: https://doi.org/10.4097/kja.21212    [Epub ahead of print]
Published online October 20, 2021.
Comparison of the clinical performance of the I-GelTM, LMA SupremeTM, and Ambu AuraGainTM in adult patients during general anesthesia: a prospective and randomized study
Tejashri Chinthavali Lakshmi1, Tanmay Tiwari1  , Jyotsna Agrawal1, Rajni Kapoor1, Vikrannth Vasanthakumar2
1Department of Anaesthesiology & Critical Care, King George’s Medical University, Lucknow, India
2Department of General Medicine, Saveetha Medical College and Hospital, Chennai, India
Corresponding author:  Tanmay Tiwari, Tel: +91-9452526270, 
Email: tanmayanesthesia@gmail.com
Received: 19 May 2021   • Revised: 17 October 2021   • Accepted: 18 October 2021
Abstract
Background
Supraglottic airway devices (SADs) are routinely used for securing the airway. In this study, the clinical performance of three SADs in adult patients under general anesthesia was compared.
Methods
American Society of Anesthesiologists physical status I-III subjects were randomly assigned to the I-GelTM (I), LMA SupremeTM (L), or Ambu AuraGainTM (A) group (30 per group). The primary objective of this study was to compare insertion times. Additionally, the ease of insertion, number of attempts, oropharyngeal leak pressure (OLP), airway maneuver requirement, difficulty with gastric tube placement, and complications were assessed.
Results
Demographic data did not differ between the groups. Group I (16.9 ± 4.9 s) had a significantly shorter time of insertion than Group L (19.6 ± 5.2 s) and Group A (22.1 ± 5.7 s) (P = 0.001). The OLP for Group A (29.8 ± 3.0 cmH2O) was higher than those for Group L (24.1 ± 6.3 cmH2O) and Group I (9.4 ± 6.1 cmH2O) (P < 0.001). The number of insertion attempts (P = 0.232), ease of insertion (P = 0.630), airway maneuver requirement (P = 0.585), difficulty with gastric tube placement (P = 0.364), and complications (P = 0.873) were not significantly different between the groups.
Conclusions
All three devices are convenient and effective for airway management in adults under general anesthesia. However, the shorter insertion time required for the I-Gel may make it more suitable for resuscitation and emergencies, while aspiration risk may be reduced with the Ambu AuraGain, given its high OLP.
Key Words: Airway management; General anesthesia; I-Gel; Laryngeal masks airway; Supraglottic devices; Ventilation
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