A randomized equivalence trial comparing the i-gel and laryngeal mask airway Supreme in children

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Laryngeal Mask Airway (LMA) Placement in a Neonatal Patient Simulator Using a Non-Inflatable Supraglottic Airway (SGA)
04:56

Laryngeal Mask Airway (LMA) Placement in a Neonatal Patient Simulator Using a Non-Inflatable Supraglottic Airway (SGA)

Published on: July 14, 2023

Narasimhan Jagannathan1, Katherine Sommers, Lisa E Sohn

  • 1Department of Pediatric Anesthesia, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University's Feinberg School of Medicine, Chicago, IL 60611, USA. simjag2000@yahoo.com

Paediatric Anaesthesia
|November 30, 2012
PubMed

Insights

The i-gel supraglottic device offers higher airway leak pressures compared to the Laryngeal Mask Airway Supreme in children. Both devices are effective for airway maintenance, with the Supreme showing faster gastric tube insertion times.

Area of Science:

  • Anesthesiology
  • Pediatric Airway Management
  • Medical Devices

Background:

  • The Laryngeal Mask Airway Supreme (Supreme) is a single-use supraglottic airway device with gastric access, available for pediatric use.
  • Supraglottic airway devices are crucial for maintaining a patent airway during anesthesia in children.

Purpose of the Study:

  • To compare the efficacy and safety of the i-gel supraglottic device versus the Laryngeal Mask Airway Supreme in pediatric patients.
  • To evaluate key performance metrics including airway leak pressure, insertion characteristics, and complication rates.

Main Methods:

  • A randomized controlled trial involving 170 children (3 months to 11 years) undergoing routine airway maintenance.
  • Patients were allocated to either the i-gel or the Supreme group.
  • Primary outcome was airway leak pressure; secondary outcomes included insertion time, success rate, gastric tube placement, and complications.

Main Results:

  • The i-gel demonstrated significantly higher airway leak pressures (20 cm H2O) compared to the Supreme (17 cm H2O) (P=0.001).
  • Insertion time, view quality, and complication rates were similar between the two devices.
  • The Supreme facilitated faster gastric tube insertion (12s) than the i-gel (14s) (P=0.01), and fewer airway manipulations were needed with the Supreme.

Conclusions:

  • The i-gel is a viable alternative to the Laryngeal Mask Airway Supreme for pediatric airway management when gastric access is needed.
  • Both devices provide effective airway maintenance, but the i-gel offers superior sealing capabilities.
Abstract

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