Comparison of five 2nd-generation supraglottic airway devices for airway management performed by novice military operators.
OBJECTIVE
Five different second-generation supraglottic airway devices, ProSeal LMA, Supreme LMA, i-gel, SLIPA, and Laryngeal Tube Suction-D, were studied. Operators were inexperienced users with a military background, combat lifesavers, nurses, and physicians.


METHODS
This was a prospective, randomized, single-blinded study. Devices were inserted in the operating room in low light conditions after induction of general anesthesia. Primary outcome was successful insertion on the first attempt while secondary aims were insertion time, number of attempts, oropharyngeal seal pressure, ease of insertion, fibre optic position of device, efficacy of ventilation, and intraoperative trauma or regurgitation of gastric contents.


RESULTS
In total, 505 patients were studied. First-attempt insertion success rate was higher in the Supreme LMA (96%), i-gel (87.9%), and ProSeal LMA (85.9%) groups than in the Laryngeal Tube Suction-D (80.6%) and SLIPA (69.4%) groups. Insertion time was shortest in the Supreme LMA (70.4 ± 32.5 s) and i-gel (74.4 ± 41.1 s) groups (p < 0.001). Oropharyngeal seal pressures were higher in the Laryngeal Tube Suction-D and ProSeal LMA groups than in other three devices.


CONCLUSIONS
Most study parameters for the Supreme LMA and i-gel were found to be superior to the other three tested supraglottic airway devices when inserted by novice military operators.
Department of Anesthesia and Intensive Medicine, 1st Medical Faculty and University Military Hospital, U Vojenske Nemocnice 1, 169 02 Prague, Czech Republic.
Tomas
T
Henlin
Department of Anesthesia and Intensive Medicine, 1st Medical Faculty and University Military Hospital, U Vojenske Nemocnice 1, 169 02 Prague, Czech Republic.
Michal
M
Sotak
Department of Anesthesia and Intensive Medicine, 1st Medical Faculty and University Military Hospital, U Vojenske Nemocnice 1, 169 02 Prague, Czech Republic.
Petr
P
Kovaricek
Department of Anesthesia and Intensive Medicine, 1st Medical Faculty and University Military Hospital, U Vojenske Nemocnice 1, 169 02 Prague, Czech Republic.
Tomas
T
Tyll
Department of Anesthesia and Intensive Medicine, 1st Medical Faculty and University Military Hospital, U Vojenske Nemocnice 1, 169 02 Prague, Czech Republic.
Lukas
L
Balcarek
Department of Anesthesia and Intensive Medicine, 1st Medical Faculty and General University Hospital, U Nemocnice 2, 128 08 Prague, Czech Republic ; University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK.
Pavel
P
Michalek
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058109:Airway Management / Q000295:instrumentation* / Q000379:methods; D002983:Clinical Competence / Q000706:statistics & numerical data*; D018153:Czech Republic; D004311:Double-Blind Method; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D008887:Military Medicine / Q000193:education* / Q000295:instrumentation; D008889:Military Personnel / Q000193:education* / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult