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

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