Comparison of clinical performance of I-GelTM, LMA SupremeTM And Ambu AuraGainTM in adult patients during general anesthesia; a prospective and randomised study

Lakshmi, Tejashri Chinthavali; Tiwari, Tanmay; Agrawal, Jyotsna; Kapoor, Rajni; Vasanthakumar, Vikrannth

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Korean J Anesthesiol > Epub ahead of print

Clinical Research Article

DOI: https://doi.org/10.4097/kja.21212 [Epub ahead of print]
Published online October 20, 2021.

Comparison of clinical performance of I-Gel^TM, LMA Supreme^TM And Ambu AuraGain^TM in adult patients during general anesthesia; a prospective and randomised 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,
Email: tanmayanesthesia@gmail.com

Received: 19 May 2021 • Revised: 17 October 2021 • Accepted: 18 October 2021

Abstract

Background
Supraglottic airway devices (SAD) are routinely used for securing the airway. Clinical performance of three SAD in adult patients under general anesthesia was compared.
Methods
American Society of Anesthesiologists physical status I-III subjects were randomly assigned to I-gel^TM (I), LMA supreme^TM (L) or Ambu Auragain^TM (A) group with 30 in each group. Time of insertion of SAD was the primary objective. Ease of insertion, number of attempts for insertion, oropharyngeal leak pressure (OLP), airway maneuver requirement, difficulty in placing gastric tube and complications were assessed.
Results
Demographic data did not differ between the groups. Group I (16.9 ± 4.9 s) had significantly shorter time of insertion in comparison to Group L (19.6 ± 5.2 s) and Group A (22.1 ± 5.7 s) (P = 0.001). OLP for group A (29.8 ± 3.0 cmH₂O) was higher than Group L (24.1 ± 6.3 cmH₂O) and Group I (9.4 ± 6.1 cmH₂O) (P < 0.001). No statistical significant difference was observed in terms of number of attempts for insertion (P = 0.232), ease of insertion (P = 0.630) airway maneuver requirement (P = 0.585), difficulty in gastric tube placement (P = 0.364) and complication (P = 0.730) in between the groups.
Conclusions
The study demonstrated that all three devices are convenient and effective to be used for airway management in adults under general anesthesia. However, shorter insertion time required for I-gel can be suitable during resuscitation and emergencies, while Ambu Auragain with maximum OLP can be useful in reducing the risk for aspiration.

Key Words: Airway management; General anesthesia; I-gel; Laryngeal masks airway; Supraglottic Devices; Ventilation