Comparison of clinical performance of laryngeal mask airway supremeTM and I-gelTM in patients undergoing elective non-laparoscopic surgeries

Supraglottic airway devices have a special niche for themselves with regards to airway management in modern anaesthesia practice. They have become a very good alternative to mask ventilation and tracheal intubation in elective surgeries and have an important place in the emergency settings. The single-use supraglottic airway devices I-gel™ and LMA-Supreme™ have been developed with the aim to overcome the limitations and improve the efficacy of currently available supraglottic airway devices like there airway sealing pressure, ease of placement but with discordant results with regards to airway sealing pressure, ease and success of placement and airway morbidity. The aim of this prospective, randomized trial was to evaluate these two airway devices in routine clinical practice. Materials and Methods: 80 patients (ASA grade1-2) were randomly allocated to two groups; Group I (I-gelTM; n=40) and Group S (LMA-SupremeTM; n=40). A size 3 or 4 (I-gelTM and LMA-SupremeTM) was used in patients and inserted by experienced anaesthesiologists who had 3 years' experience and had performed 20 successful insertions with each device. First attempt success rate, time for insertion and airway sealing pressure of each device was measured. Airway sealing pressure with LMA-SupremeTM was measured at an intracuff pressure of 60cmH2O. Patients were enquired after surgery for the presence of any dysphagia, sore-throat or hoarseness of voice. Data were analyzed statistically using unpaired ‘t' test and Chi-square test. A p value of < 0> Results: The first attempt success rate for I-gelTM was 92.5% and for LMA-SupremeTM was 87.5%. Ventilation was established in 19.7 seconds (range 14-24 seconds) in the I-gelTM group and in 24.2 seconds (range 19-29seconds) in LMA-SupremeTM group (p<0>TM 23.2 cmH2O; LMA-SupremeTM 22.4 cmH2O; p>0.001). Conclusion: Both I-gelTM and LMA SupremeTM are disposable, latex-free devices which do not need any digital or introducer tool for insertion. They have good airway sealing pressures, ease of insertion and low airway morbidity especially with I-gel, so they can be a good choice in patients undergoing elective surgeries.