Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.02.042
Brazilian Journal of Anesthesiology
Original Investigation

Comparison of Proseal LMA with i-Gel in children under controlled ventilation: a prospective randomised clinical study

Comparação de ProSeal LMA com i-Gel em crianças sob ventilação controlada: um estudo clínico prospectivo randomizado

Praveen Shiveshi, Tejesh Channasandra Anandaswamy

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Abstract

Background
Supraglottic airway device is presently the most common modality of airway management in children for short surgical procedures. The i-gel is one such novel supraglottic airway device with a non-inflatable cuff. The objective of the present study was to evaluate the efficiency of i-gel compared to LMA Proseal regarding oropharyngeal leak pressure, insertion time, ease of insertion, and fibreoptic view of larynx.

Methods
After obtaining ethical clearance and parental consent, 70 children aged 2–10 years, weighing 10–30 kgs were randomised to receive LMA Proseal or i-gel for airway management. Data with respect to oropharyngeal leak pressure, insertion time, ease of insertion, number of attempts, and fibreoptic score were collected. The primary outcome was the oropharyngeal leak pressure with the two supraglottic airway devices measured by manometric stability.

Results
Demographic data were comparable between the two groups. The oropharyngeal leak pressure (LMA Proseal vs. i-gel, 20.51 ± 4.71 cmH2O vs. 19.57 ± 5.71 cmH2O), ease of insertion, number of attempts, and fibreoptic view score was similar between the two groups. The insertion time was faster with i-gel (22.63 ± 5.79 s) compared to LMA Proseal (43.26 ± 7.85 s).

Conclusion
I-gel was similar to LMA Proseal with respect to oropharyngeal leak pressure in children under controlled ventilation.

Keywords

Laryngeal masks,  Airway management,  Pediatrics,  Anesthesia,  General

Resumo

Introdução: O dispositivo supraglótico das vias aéreas é atualmente a modalidade mais comum de manejo das vias aéreas em crianças para procedimentos cirúrgicos curtos. O i-Gel é um desses novos dispositivos supraglóticos das vias aéreas com um manguito não inflável. O objetivo do presente estudo foi avaliar a eficiência do i-Gel em comparação com o LMA ProSeal em relação à pressão de fuga orofaríngea, tempo de inserção, facilidade de inserção e visão da laringe por fibra óptica. Métodos: Após obter autorização ética e consentimento dos pais, 70 crianças de 2 a 10 anos, pesando 10 a 30 kg, foram randomizadas para receber LMA ProSeal ou i-Gel para manejo das vias aéreas. Dados relativos à pressão de fuga orofaríngea, tempo de inserção, facilidade de inserção, número de tentativas e pontuação de fibra óptica foram coletados. O desfecho primário foi a pressão de fuga orofaríngea com os dois dispositivos supraglóticos das vias aéreas medidos pela estabilidade manométrica. Resultados: Os dados demográficos foram comparáveis entre os dois grupos. A pressão de fuga orofaríngea (LMA ProSeal versus i-Gel, 20,51±4,71 cmH2O versus 19,57±5,71 cmH2O), facilidade de inserção, número de tentativas e pontuação de visão de fibra óptica foi semelhante entre os dois grupos. O tempo de inserção foi mais rápido com o i-Gel (22,63±5,79 s) em comparação com o LMA ProSeal (43,26±7,85 s). Conclusão: O I-Gel foi semelhante ao LMA ProSeal no que diz respeito à pressão de fuga orofaríngea em crianças sob ventilação controlada.

Palavras-chave

Máscaras laríngeas; Gestão das vias aéreas; Pediatria; Anestesia geral

References

1 S. Ramesh, R. Jayanthi, S.R. Archana Paediatric airway management: What is new? Indian J Anaesth., 56 (2012), pp. 448-453

2 M.A. Hendinezhad, A. Babaei, A. Gholipour Baradari, et al. Comparing supraglottic airway devices for airway management during surgery in children: a review of literature J Pediatric Rev., 7 (2019), pp. 89-98

3 T. Hoşten, Y. Gürkan, A. Kuş, et al. Comparison of Pro Seal LMA with S upreme LMA in paediatric patients Acta Anaesthesiol Scand., 57 (2013), pp. 996-1001

4 S. Saran, S.K. Mishra, A.S. Badhe, et al. Comparison of i-gel supraglottic airway and LMA-ProSeal™ in pediatric patients under controlled ventilation J Anaesthesiol Clin Pharmacol., 30 (2014), pp. 195-198

5 R. Beringer, F. Kelly, T. Cook, et al. A cohort evaluation of the paediatric i-gel™ airway during anaesthesia in 120 children Anaesthesia., 66 (2011), pp. 1121-1126

6 R. Nirupa, S. Gombar, V. Ahuja, et al. A randomised trial to compare i-gel and ProSeal™ laryngeal mask airway for airway management in paediatric patients Indian J Anaesth., 60 (2016), pp. 726-731

7 C. Keller, J. Brimacombe, K. Keller, et al. Comparison of four methods for assessing airway sealing pressure with the laryngeal mask airway in adult patients Br J Anaesth., 82 (1999), pp. 286-287

8 M. Lopez-Gil, J. Brimacombe, C. Keller A comparison of four methods for assessing oropharyngeal leak pressure with the laryngeal mask airway (LMA™) in paediatric patients Paediatr Anaesth., 11 (2001), pp. 319-321

9 J. Brimacombe, A. Berry A proposed fiber-optic scoring system to standardize the assessment of laryngeal mask airway position Anesth Analg., 76 (1993), p. 457

10 L. Gasteiger, J. Brimacombe, E. Oswald, et al. LMA Pro SealTM vs. i-GelTM in ventilated children: A randomised, crossover study using the size 2 mask Acta Anaesthesiol Scand., 56 (2012), pp. 1321-1324

11 R. Acharya, N.M. Dave Comparison between i-gel airway an the proseal laryngeal mask airway in pediatric patients undergoing general anesthesia Pediatric Anesth Crit Care J., 4 (2016), pp. 97-102

12 R. Goyal, R.N. Shukla, G. Kumar Comparison of size 2 i-gel supraglottic airway with LMA-ProSeal™ and LMA-Classic™ in spontaneously breathing children undergoing elective surgery Paediatr Anaesth., 22 (2012), pp. 355-359

13 S. Mitra, B. Das, S.N. Jamil Comparison of Size 2.5 i-gel™ with ProSeal LMA™ in anaesthetised, paralyzed children undergoing elective surgery N Am J Med Sci., 4 (2012), pp. 453-457

14 O. Tokgoz, A. Tufek, S.G. Beyaz, et al. Comparison of the efficacies of I-gel™ and LMA-Proseal™ for airway management in pediatric patients Turk J Med Sci., 43 (2013), pp. 208-213

15 J.R. Brimacombe Seal with the respiratory and gastrointestinal tracts Laryngeal mask anesthesia: Principles and Practice (2nd ed), Saunders, Philadelphia (2005), pp. 137-152

16 N. Komasawa, I. Nishihara, S. Tatsumi, T. Minami Does prewarming the i-gel supraglottic airway device fit the larynx better compared to keeping it at room temperature for non-paralysed, sedated patients: a randomised controlled trail BMJ Open., 5 (2015), Article e006653

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