title: A randomized equivalence trial comparing the i-gel and laryngeal mask airway Supreme in children.
abstract: BACKGROUND
  The laryngeal mask airway Supreme (Supreme) is a new single-use supraglottic device with gastric access capability now available in all sizes for children.
  
  
  OBJECTIVE
  To compare the i-gel with the Supreme in children for routine airway maintenance.
  
  
  METHODS
  One hundred and seventy children, aged 3 months to 11 years, 5-50 kg in weight, were randomly assigned to receive either the i-gel or the Supreme. The primary outcome measured was airway leak pressure. Secondary outcomes included the following: ease and time for insertion, insertion success rate, fiberoptic grade of view, ease of gastric tube placement, number of airway manipulations, quality of airway during anesthetic maintenance, and complications.
  
  
  RESULTS
  A total of 168 patients were assessed for the outcomes. The median (IQR [range]) airway leak pressure for the i-gel was higher than with the Supreme, 20 (18-25 [9-40]) cm H(2)O vs 17 (14-22 [10-40]) cm H(2)O, respectively (P = 0.001). There were no differences in the time for device insertion, fiberoptic grade of view, quality of airway, and complications. Median (IQR[range]) time of successful insertion of a gastric tube was faster with the Supreme, 12 (9.2-14.3 [5.2-44.2]) s than with the i-gel, 14 (11.9-19 [6.9-75]) s; P = 0.01. The number of airway manipulations during placement was higher with the i-gel than with the laryngeal mask airway Supreme (12 vs 13 patients), P = 0.02.
  
  
  CONCLUSIONS
  In infants and children, when a single-use supraglottic device with gastric access capabilities is required, the i-gel demonstrated higher airway leak pressures and can be a useful alternative to the Supreme.
authors.affiliation: Department of Pediatric Anesthesia, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University's Feinberg School of Medicine, Chicago, IL 60611, USA. simjag2000@yahoo.com
authors.forename: Narasimhan
authors.initials: N
authors.lastname: Jagannathan
authors.forename: Katherine
authors.initials: K
authors.lastname: Sommers
authors.forename: Lisa E
authors.initials: LE
authors.lastname: Sohn
authors.forename: Amod
authors.initials: A
authors.lastname: Sawardekar
authors.forename: Ravi D
authors.initials: RD
authors.lastname: Shah
authors.forename: Isabella I
authors.initials: II
authors.lastname: Mukherji
authors.forename: Steven
authors.initials: S
authors.lastname: Miller
authors.forename: Polina
authors.initials: P
authors.lastname: Voronov
authors.forename: Sally
authors.initials: S
authors.lastname: Seraphin
mesh_terms: D058109:Airway Management; D000769:Anesthesia, Inhalation / Q000295:instrumentation / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003627:Data Interpretation, Statistical; D005260:Female; D005336:Fiber Optic Technology; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007441:Intubation, Gastrointestinal; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D007830:Larynx / Q000033:anatomy & histology; D008297:Male; D012121:Respiration, Artificial; D016896:Treatment Outcome