AuraGain™ versus i-gel™ for bronchoscopic intubation under continuous oxygenation: A randomised controlled trial

Area of Science:

• Anesthesiology
• Critical Care Medicine
• Respiratory Medicine

Background:

• Second-generation supraglottic airway (SGA) devices are recommended for oxygenation when mask ventilation and tracheal intubation fail.
• Tracheal intubation can be achieved through an SGA using a bronchoscope, providing a secure airway.
• Comparing different SGA devices is crucial for optimizing airway management strategies.

Purpose of the Study:

• To compare the AuraGain™ and i-gel™ supraglottic airway devices as conduits for flexible bronchoscopic intubation.
• To evaluate the total time for airway management and success rates of intubation through these devices.
• To assess the performance of these devices in a general patient population with variable anesthesiologist experience.

Main Methods:

• A randomized trial involving 100 patients allocated to either the AuraGain™ or i-gel™ group.
• 25 anesthesiologists each performed two intubations with each device in a random order.
• The primary outcome was the total time for airway management, from device insertion to successful intubation confirmed by capnography.

Main Results:

• Overall, 87% of patients were successfully intubated through the allocated SGA.
• No significant difference was found in the total time for airway management between the AuraGain™ (227s) and i-gel™ (199s) groups (p=0.076).
• The i-gel™ showed a significantly shorter placement time (37s) compared to the AuraGain™ (54s) (p<0.001).

Conclusions:

• There is no significant difference in the total time for airway management when using AuraGain™ versus i-gel™ for bronchoscopic intubation.
• While i-gel™ placement was faster, overall airway management time did not differ significantly between the two devices.
• Both devices facilitate oxygenation, but further research may explore factors influencing intubation success rates.