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Comparison of the Intersurgical Solus™ laryngeal mask airway and the i-gel supralaryngeal device

Authors

Amini S., Khoshfetrat M.

Publication

Anaesthesia 2010; 65 (8): 805-809.

Summary

  • A study to compare the performances of the Solus™ laryngeal mask airway and the i-gel™ supraglottic airway devices in patients undergoing elective surgery requiring general anaesthesia
  • The Solus™ laryngeal mask airway was associated with a significantly better oropharyngeal seal than the i-gel™
  • The fibre-optic view of the glottis was significantly better with the Solus™ laryngeal mask airway than with the i-gel™

Objectives:

  • To compare the performances of the Solus™ laryngeal mask airway and the i-gel™ supraglottic airway devices in patients undergoing elective surgery requiring general anaesthesia

Method:

  • This was a prospective, randomised trial Eligible patients were aged ≥15 years, had normal airways and were American Society of Anesthesiologists physical status 1 or 2
  • The primary outcome of the study was to compare the oropharyngeal leak pressure with the Solus™ laryngeal mask airway and the i-gel™ devices
  • Secondary outcomes included
    • Fibre-optic view of the glottis
    • Peak airway pressure
    • Time taken (and number of attempts) to insert the device (from grasping the device to the observation of a square wave capnograph trace)
    • Minor and major airway interventions
    • Ventilatory parameters (e.g. oxygen saturation, endexpiratory CO2, peak airway pressure)
    • Peri-operative complications

Results:

  • Patients (mean body mass index of 22.3–24.3 kg/m2) were randomised to receive the Solus™ laryngeal mask airway (n=60) or the i-gel™ (n=60)
  • Successful insertion on the first attempt was achieved in the majority of patients who received the Solus™ laryngeal mask airway (48 of 60 patients) and the i-gel™ (46 of 60 patients)
    • Due to an inability to achieve adequate ventilation, a tracheal tube was employed in 1 patient who received the Solus™ laryngeal mask airway and in 4 patients who received the i-gel™
    • The insertion time was similar in patients who received the Solus™ laryngeal mask airway and the i-gel™ (24.2 vs. 20.0 seconds)
  • Oropharyngeal leak pressure was significantly higher and the view of the glottis was significantly better in patients who received the Solus™ laryngeal mask airway versus the i-gel™ (Figures 1 and 2)
Figure 1. Oropharyngeal leak pressure with the Solus™ laryngeal mask airway and the i-gel™ supraglottic airway devices (data are shown as mean ± standard deviation).

Figure 2. Fibre-optic view of the glottis with the Solus™ laryngeal mask airway and the i-gel™ supraglottic airway devices.

  • Peak airway pressure was 14.2 cm H2O in the Solus™ laryngeal mask airway recipients and 13.3 cm H2O in i-gel™ recipients
  • There were no significant between-group differences in the various ventilatory parameters assessed and in the incidence of blood on the devices following their removal
  • The need for airway interventions was significantly (p<0.01) lower in patients who received the Solus™ laryngeal mask airway (8 of 59 patients) versus the i-gel™ (28 of 56 patients)
  • The incidences of sore throat and dysphagia in the post-operative period were similarly low in the two groups of patients
  • There were no reports of dysphonia or peri-operative complications in any patients

Conclusions:

  • The Solus™ laryngeal mask airway had a significantly better oropharyngeal seal than the i-gel™ in patients undergoing elective surgery requiring general anaesthesia
  • The Solus™ laryngeal mask airway was associated with a significantly better fibre-optic view of the glottis compared with the i-gel™