Abstract

Background: The intracuff pressure of supraglottic devices in children should be maintained at 40 cmH2O. We compared the oropharyngeal leak pressures (OLP) of the LMA Proseal, AAG, and I-gel.

Research design and Methods: After obtaining IRB approval, 120 children (aged 1–10 years) were randomly divided into three groups to undergo elective procedures under general anesthesia: Ambu AuraGain (Group A, N=40), I-gel (Group I, N=40), or LMA Proseal (Group P, N=40). We compared OLP post-device insertion at 5 and 30 min, insertion characteristics, and Brimacombe scores.

Results: The mean (SD) OLP was significantly higher with I-gel as compared to the AAG and LMA Proseal at 5 min [28.30(1.77) vs. 24.38(1.90) vs. 24.30(2.45); p<0.001] and 30 min post device insertion [28.98(1.27) vs. 24.77(1.83) vs. 24.30(2.45); p<0.001]. The median (IQR) time to achieve effective ventilation was significantly shorter in group-I [16s(15-16.25) vs. 18.5s(18-20) vs. 18s(17.75-19), respectively p<0.001]. The anatomical alignment of the device to the glottic opening was significantly better in groups A and P (p<0.001). First-attempt success, ease of device insertion, and gastric catheter insertion were similar in all patients.

Conclusion: All three devices provided effective ventilation in pediatric patients undergoing elective surgery under general anesthesia. The I-gel was better than the AAG and LMA Proseal in terms of higher OLP.

Trial registration: CTRI/2023/10/059077[Registered on: 25/10/2023].