Korean J Anesthesiol.  2022 Aug;75(4):316-322. 10.4097/kja.21212.

Comparison of the clinical performance of the i-gel^TM, LMA Supreme^TM, and Ambu AuraGain^TM in adult patients during general anesthesia: a prospective and randomized study

• Lakshmi TC
• Tiwari T
• Agrawal J
• Kapoor R
• Vasanthakumar V

• KMID: 2532110
• DOI: http://doi.org/10.4097/kja.21212

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.

Keyword

Airway management; General anesthesia; I-Gel; Laryngeal masks airway; Supraglottic devices; Ventilation