title: Performance of the pediatric-sized i-gel compared with the Ambu AuraOnce laryngeal mask in anesthetized and ventilated children.
abstract: BACKGROUND
  This prospective, randomized, controlled trial compares the performance of the pediatric i-gel (Intersurgical Ltd., Wokingham, United Kingdom) with the Ambu AuraOnce laryngeal mask (Ambu A/S, Ballerup, Denmark) in anesthetized and ventilated children.
  
  
  METHODS
  With ethics committee approval and written informed consent, the authors included 208 children, aged 0-17 yr, scheduled for elective day-surgery under general anesthesia. The primary outcome variable was oropharyngeal leak pressure. Other outcome variables were first-attempt and overall success, time to sufficient ventilation, and adverse events.
  
  
  RESULTS
  Demographic data did not differ between groups. The leak pressure of the i-gel was significantly higher than the leak pressure of the Ambu (mean ± SD: 22 ± 5 cm H₂O vs. 19 ± 3, P < 0.01). First-attempt success was 91% for the i-gel and 93% for the Ambu (P = 0.50). Overall success was 93% for the i-gel versus 98% for the Ambu (P = 0.10). Successfully inserted i-gels needed to be secured by taping in place to ensure the seal in 44% (0% with the Ambu, P < 0.01). Insertion was faster with the Ambu (24 ± 8 s vs. 27 ± 11, P = 0.02). There were no major side effects with either device.
  
  
  CONCLUSIONS
  The leak pressure of the i-gel was statistically but not clinically significantly higher than the leak pressure of the Ambu. Time to insertion was longer with the i-gel. Both airway devices are suitable for positive pressure ventilation with high success rates in infants and children. Because the i-gel is prone to sliding out, it must be taped in place to avoid loss of the airway.
authors.affiliation: Department of Anesthesiology and Pain Therapy, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.
authors.forename: Lorenz G
authors.initials: LG
authors.lastname: Theiler
authors.forename: Maren
authors.initials: M
authors.lastname: Kleine-Brueggeney
authors.forename: Barbara
authors.initials: B
authors.lastname: Luepold
authors.forename: Franziska
authors.initials: F
authors.lastname: Stucki
authors.forename: Stefan
authors.initials: S
authors.lastname: Seiler
authors.forename: Natalie
authors.initials: N
authors.lastname: Urwyler
authors.forename: Robert
authors.initials: R
authors.lastname: Greif
mesh_terms: D000293:Adolescent; D058109:Airway Management / Q000009:adverse effects / Q000295:instrumentation*; D000768:Anesthesia, General / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004209:Disposable Equipment; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017214:Laryngeal Masks / Q000009:adverse effects; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012121:Respiration, Artificial / Q000009:adverse effects; D016896:Treatment Outcome