[Supreme laryngeal mask airway vs the I-gel supraglottic airway in patients under general anesthesia and mechanical ventilation with no neuromuscular block: a randomized clinical trial].
OBJECTIVE
The Supreme Laryngeal Mask Airway (SLMA) and the I-gel Supraglottic Airway (IGSA) are recently introduced devices incorporating a gastric channel. This study assessed the ease of insertion of the devices and their efficacy in mechanical ventilation.


METHODS
Eighty-five patients undergoing major outpatient surgery under general anesthesia were randomized to 2 groups for intubation using the SLMA or the IGSA. After induction of general anesthesia, the assigned mask was inserted and positioning was checked with a fiberoptic scope. Ease of insertion was evaluated. Seal pressure was measured and the following ventilatory parameters were recorded 10, 30, and 60 minutes after the start of surgery: peak pressure, mean pressure, compliance, and the ratio of tidal volume to respiratory frequency. Conditions at the moment of inserting the nasogastric tube were also noted.


RESULTS
First-attempt placement of the airway was possible in 95.2% of patients using the SLMA and in 86% using the IGSA (P = .147). The mean times required for placement were 27.1 seconds for the SLMA and 32.5 seconds for the IGSA (P = .195). The nasogastric tube was inserted on the first attempt in 97.6% of patients with an SLMA and in 85.7% of patients with an IGSA. The mean times required for tube insertion were 9.5 seconds through the SLMA and 22.1 seconds through the IGSA (P < .001). Seal pressure and compliance were similar in the 2 groups at the start of surgery and at 10, 30, and 60 minutes. The incidences of complications during surgery and at 90 minutes were likewise similar (P = .945 and P = .698, respectively).


CONCLUSIONS
The SLMA and the IGSA are easy to put into position on the first attempt. It is easier to insert the nasogastric tube through the gastric channel of the SLMA. Both devices provide an effective seal and the incidences of complications were similar for both in the patients we studied.
Fernández Díez
A
A
Servicio de Anestesiología y Reanimación, Hospital de León. aidoblas@telefonica.net
Pérez Villafañe
A
A
Bermejo González
J C
JC
Marcos Vidal
J M
JM
D000328:Adult; D000768:Anesthesia, General; D004867:Equipment Design; D006801:Humans; D017214:Laryngeal Masks; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial