A randomized comparative study of three supraglottic airway devices for controlled ventilation in anesthetized patients

Manoj Sharma; Bimla Sharma; Manish Gupta; Bhuwan Chand Panday; Chand Sahai; Jayashree Sood

doi:10.4103/joacp.JOACP_465_20

A randomized comparative study of three supraglottic airway devices for controlled ventilation in anesthetized patients

J Anaesthesiol Clin Pharmacol. 2022 Apr-Jun;38(2):221-227. doi: 10.4103/joacp.JOACP_465_20. Epub 2021 Nov 18.

Authors

Manoj Sharma¹, Bimla Sharma¹, Manish Gupta¹, Bhuwan Chand Panday¹, Chand Sahai¹, Jayashree Sood¹

Affiliation

¹ Institute of Anaesthesiology, Pain and Perioperative Medicine, Sir Ganga Ram Hospital, Old Rajinder Nagar, New Delhi, India.

Abstract

Background and aims: The LMA® ProSeal™, LMA® Supreme™ and Ambu® AuraGain™ are second-generation supraglottic airway devices (SADs) with integrated gastric access. In this study, we compared the clinical performance of these three devices in adults for controlled ventilation in anesthetized paralysed patients.

Material and methods: Two hundred and seventy adults, American Society of Anesthesiologists (ASA) Physical Status I-III, undergoing elective surgical procedures, were randomized into three groups with 90 patients in each: Group 1: LMA® ProSeal™, Group 2: LMA® Supreme™ and Group 3: Ambu® AuraGain™. All the three devices were evaluated for oropharyngeal seal pressure (OSP) and other parameters: ease and the number of attempts at device placement, fibreoptic laryngeal view and intraoperative and postoperative complications.

Results: In the present study, the mean OSP was 38.9 ± 3.050 cm H₂O in the LMA ProSeal™ group, 37.41 ± 4.097 cm H₂O in LMA® Supreme™ group and 37.32 ± 3.740 cm H₂O in Ambu® AuraGain™ group. The difference was found to be statistically significant (P = 0.006). The three groups were comparable for the ease of device insertion, number of attempts at device placement, fibreoptic laryngeal view, intraoperative and postoperative complications.

Conclusion: In this study, we found that the LMA® ProSeal™ provided the highest OSP in comparison to the other two devices, even though this difference is not clinically relevant. The use of Ambu® AuraGain™ was associated with difficult and lowest first-time insertion success rate (P < 0.001) along with an increased incidence of airway trauma as compared to the other two SADs.

Keywords: Ambu AuraGain; LMA ProSeal; LMA supreme oropharyngeal seal pressure; supraglottic airway devices.