Pattern of Usage of Supraglottic Airway Devices in Pediatric Patients among Anesthesiologists

Supraglottic airway devices (SADs) have become integral to pediatric anesthesia, offering a less invasive alternative to endotracheal intubation with advantages in ease of insertion, hemodynamic stability, and reduced airway trauma. Various SADs, such as the classic laryngeal mask airway (LMA), ProSeal LMA, I-gel, and Ambu AuraOnce are available, each differing in design, seal pressure, and clinical indications. Despite their widespread use, practice patterns among anesthesiologists regarding SAD selection, insertion techniques, and perioperative management in pediatric patients vary considerably, often influenced by training, institutional protocols, and device availability.

This study aimed to assess the current trends, preferences, and clinical practices related to the use of SADs among anesthesiologists managing pediatric patients.

A cross-sectional, questionnaire-based study was conducted among anesthesiologists working in tertiary-care hospitals, pediatric surgical centers, and academic institutions across India. A structured, validated Google Form was circulated electronically between March and August 2025. The questionnaire included sections on demographic data, years of anesthesia experience, types of SADs commonly used, criteria guiding device selection, perceived advantages and complications, and frequency of use across elective and emergency procedures. Data were analyzed using descriptive statistics and Chi-square tests for association.

Out of 248 respondents, 232 (93.5%) reported routine use of SADs in pediatric anesthesia. The I-gel was the most frequently used device (64.6%), followed by the ProSeal LMA (21.8%) and classic LMA (10.7%). Experience significantly influenced device preference (P < 0.01): anesthesiologists with over 10 years' experience favored ProSeal LMA for its higher seal pressure, whereas younger practitioners predominantly used I-gel due to ease of insertion and single-use design. Most respondents (71.9%) preferred SADs for short elective procedures, while 19.2% used them in emergencies. Common complications included minor airway leaks (14.3%) and postoperative sore throat (8.5%), with no reports of aspiration. Institutional training and device availability were cited as key determinants of choice.

The I-gel has emerged as the preferred SAD among anesthesiologists in pediatric practice, primarily due to its user-friendliness and safety profile. Although traditional LMAs remain relevant, trends indicate a gradual shift toward second-generation devices offering better sealing and gastric access. Continuous training and evidence-based guidelines could further optimize pediatric airway management.