title: Success rate of airway devices insertion: laryngeal mask airway versus supraglottic gel device.
abstract: BACKGROUND
  The main important method for airway management during anesthesia is endotracheal intubation. Laryngeal mask airway (LMA) and supraglottic gel device (I-Gel) are considered alternatives to endotracheal tube.
  
  
  OBJECTIVE
  This study sought to assess the success rate of airway management using LMA and I-Gel in elective orthopedic surgery.
  
  
  METHODS
  This single-blinded randomized clinical trial was performed on 61 ASA Class 1 and 2 patients requiring minor orthopedic surgeries. Patients were randomly allocated to two groups of LMA and I-Gel. Supraglottic airway placement was categorized into three groups regarding the number of placement attempts, i.e. on the first, second, and third attempts. Unsuccessful placement on the third attempt was considered failure and endotracheal tube was used in such cases. The success rate, insertion time, and postoperative complications such as bleeding, sore throat, and hoarseness were recorded.
  
  
  RESULTS
  In the I-Gel group, the success rate was 66.7% for placement on the first attempt, 16.7% for the second, and 3.33% for the third attempt. In the LMA group, the success rates were 80.6% and 12.9% for the first and second attempts, respectively. Failure in placement occurred in four cases in the I-Gel and two cases in LMA groups. The mean insertion time was not significantly different between two groups (21.35 seconds in LMA versus 27.96 seconds in I-Gel, P = 0.2). The incidence of postoperative complications was not significantly different between study groups.
  
  
  CONCLUSIONS
  I-Gel can be inserted as fast as LMA with adequate ventilation in patients and has no major airway complications. Therefore, it could be a good alternative to LMA in emergency airway management or general anesthesia.
authors: Department of Anesthesiology and Pain Medicine, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors: Alireza
authors: A
authors: Pournajafian
authors: Department of Anesthesiology, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors: Mahzad
authors: M
authors: Alimian
authors: Department of Anesthesiology and Pain Medicine, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors: Faranak
authors: F
authors: Rokhtabnak
authors: Department of Anesthesiology and Pain Medicine, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors: Mohammadreza
authors: M
authors: Ghodraty
authors: Department of Anesthesiology and Pain Medicine, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors: Mozhgan
authors: M
authors: Mojri
keywords: General Anesthesia; Laryngeal Mask; Mechanical Ventilation