title: Randomized prospective trial comparing two supraglottic airway devices: i-gel™ and LMA-Supreme™ in paralyzed patients.
abstract: OBJECTIVE
  Many features can influence the choice of a supraglottic airway device (SAD), including ease of insertion, adequate ventilation pressures and lack of adverse effects. The goal of this randomized prospective trial was to compare the performance of the i-gel™ with that of the LMA-Supreme™.
  
  
  METHODS
  One hundred adult patients (American Society of Anesthesiologists I-III) scheduled to undergo elective surgery under general anesthesia were randomized to either an i-gel (n = 50) or an LMA-Supreme (n = 50). The primary objective was to compare ventilation pressures. Secondary objectives included time and number of attempts needed to introduce the device, adverse effects, and repositioning. The endoscopic view of the glottic aperture and the position of the drain tubes in relation to the esophagus were also evaluated.
  
  
  RESULTS
  The devices were inserted successfully in 46 (92%) patients in both groups. There was no significant difference in the [mean (SD)] leak pressure [i-gel: 23 (7) cm H2O vs LMA-Supreme: 21 (8) cm H2O; P = 0.14] or peak inspiratory pressure between both devices. Insertion time was shorter with the i-gel than with the LMA-Supreme [19 (7) sec vs 27 (17) sec, respectively; P = 0.003]. The vocal cords were completely visualized more often through the i-gel (70%) than through the LMA-Supreme (50%) (P = 0.007). Esophageal mucosa was easily visualized through the drain port in all but four patients, two patients in each group. There was no difference between groups regarding preoperative or postoperative complications. Postoperative patient discomfort was generally mild and comparable between both devices.
  
  
  CONCLUSIONS
  Both the LMA-Supreme and the i-gel offer similar performance for positive pressure ventilation in paralyzed patients during general anesthesia. The i-gel was associated with a slightly faster insertion time and better fibrescopic visualization of the glottis. This trial was registered at Clinicaltrials.gov: NCT01001078.
authors.affiliation: Département d'anesthésiologie, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Pavillon Hôpital Saint-Luc, Montréal, QC, Canada.
authors.forename: Nikola
authors.initials: N
authors.lastname: Joly
authors.forename: Louis-Pierre
authors.initials: LP
authors.lastname: Poulin
authors.forename: Issam
authors.initials: I
authors.lastname: Tanoubi
authors.forename: Pierre
authors.initials: P
authors.lastname: Drolet
authors.forename: François
authors.initials: F
authors.lastname: Donati
authors.forename: Patrick
authors.initials: P
authors.lastname: St-Pierre
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D017214:Laryngeal Masks / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000503:physiopathology; D011175:Positive-Pressure Respiration; D011446:Prospective Studies