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Open Access Highly Accessed Research article

Randomized comparison of the i-gel™, the LMA Supreme™, and the Laryngeal Tube Suction-D using clinical and fibreoptic assessments in elective patients

Sebastian G Russo1*, Stephan Cremer1, Tamara Galli12, Christoph Eich13, Anselm Bräuer1, Thomas A Crozier1, Martin Bauer1 and Micha Strack4

Author Affiliations

1 Department of Anaesthesiology, Emergency and Intensive Care Medicine, University Medical Centre Göttingen, Robert-Koch-Straße 40, Göttingen, 37083, Germany

2 Current affiliation: Department of Anaesthesia and Emergency Care, University Hospital San Giovanni Battista di Torino, Turin, Italy

3 Current affiliation: Department of Anaesthesia, Paediatric Intensive Care and Emergency Medicine, Children’s Hospital Auf der Bult, Hannover, Germany

4 Georg-Elias-Müller Institute for Psychology, Georg-August University, Göttingen, Germany

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BMC Anesthesiology 2012, 12:18  doi:10.1186/1471-2253-12-18

Published: 7 August 2012

Abstract

Background

The i-gel™, LMA-Supreme (LMA-S) and Laryngeal Tube Suction-D (LTS-D) are single-use supraglottic airway devices with an inbuilt drainage channel. We compared them with regard to their position in situ as well as to clinical performance data during elective surgery.

Methods

Prospective, randomized, comparative study of three groups of 40 elective surgical patients each. Speed of insertion and success rates, leak pressures (LP) at different cuff pressures, dynamic airway compliance, and signs of postoperative airway morbidity were recorded. Fibreoptic evaluation was used to determine the devices’ position in situ.

Results

Leak pressures were similar (i-gel™ 25.9, LMA-S 27.1, LTS-D 24.0 cmH2O; the latter two at 60 cmH2O cuff pressure) as were insertion times (i-gel™ 10, LMA-S 11, LTS-D 14 sec). LP of the LMA-S was higher than that of the LTS-D at lower cuff pressures (p <0.05). Insertion success rates differed significantly: i-gel™ 95%, LMA-S 95%, LTS-D 70% (p <0.05). The fibreoptically assessed position was more frequently suboptimal with the LTS-D but this was not associated with impaired ventilation. Dynamic airway compliance was highest with the i-gel™ and lowest with the LTS-D (p <0.05). Airway morbidity was more pronounced with the LTS-D (p <0.01).

Conclusion

All devices were suitable for ventilating the patients’ lungs during elective surgery.

Trial registration

German Clinical Trial Register DRKS00000760

Keywords:
Laryngeal mask airway; Leak pressure; Laryngeal Tube