Damodaran Srinath, Sethi Sameer, Malhotra Surender Kumar, Samra Tanvir, Maitra Souvik, Saini Vikas
Department of Anaesthesia, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Saudi J Anaesth. 2017 Oct-Dec;11(4):390-395. doi: 10.4103/sja.SJA_149_17.
Various randomized controlled trials and a meta-analysis have compared i-gel™ and laryngeal mask airway Supreme™ (LMA-S™) in adult patients and found that both the devices provided equivalent oropharyngeal leak pressure (OLP). However, no randomized controlled trial has compared air-Q™ with i-gel™ and LMA-S™ in adult patient. Hence, we designed this study to compare air-Q™ with LMA-S™ and i-gel™ in adult patients.
A total of 75 adult patients of the American Society of Anesthesiologists physical status I/II of both sexes, between 18 and 60 years, were included in this prospective randomized controlled trial conducted in a tertiary care center. Randomization of patients was done in three equal groups according to the insertion of supraglottic airway device by a computer-generated random number sequence: group air-Q™ ( = 25), group i-gel™ ( = 25), and group LMA-S™ ( = 25). Primary outcome of this study was OLP. We also recorded time for successful placement of device, ease of device insertion, number of attempts to insert device, and ease of gastric tube insertion along with postoperative complications.
The mean ± standard deviation OLP of air-Q™, i-gel™, and LMA-S™ was 26.13 ± 4.957 cm, 23.75 ± 5.439 cm, and 24.80 ± 4.78 cm HO ( = 0.279). The first insertion success rate for air-Q™, i-gel™, and LMA-S™ was 80%, 76%, and 92%, respectively ( = 0.353). The insertion time of air-Q™, i-gel™, and LMA-S™ was 20.6 ± 4.4, 14.8 ± 5.4, and 15.2 ± 4.7 s, respectively ( = 0.000). Time taken for air-Q™ insertion was significantly higher than time taken for i-gel™ (mean difference 5.8 s, < 0.0001) and LMA-S™ (mean difference 5.4 s, = 0.0001) insertion. Postoperative complications were similar with all three devices.
We concluded that air-Q™, i-gel™, and LMA-S™ were equally efficacious in terms of routine airway management in adult patients with normal airway anatomy.
多项随机对照试验及一项荟萃分析对成年患者使用i-gel™和喉罩气道Supreme™（LMA-S™）进行了比较，发现这两种装置的口咽漏气压（OLP）相当。然而，尚无随机对照试验对成年患者使用Air-Q™与i-gel™和LMA-S™进行比较。因此，我们设计了本研究，以比较成年患者使用Air-Q™与LMA-S™和i-gel™的情况。
本前瞻性随机对照试验在一家三级医疗中心进行，共纳入75例年龄在18至60岁之间、美国麻醉医师协会身体状况分级为I/II级的成年患者，男女不限。根据计算机生成的随机数字序列将患者随机分为三组，每组25例，分别为Air-Q™组、i-gel™组和LMA-S™组。本研究的主要结局指标为OLP。我们还记录了装置成功置入的时间、装置置入的难易程度、装置置入的尝试次数、胃管置入的难易程度以及术后并发症。
Air-Q™、i-gel™和LMA-S™的平均±标准差OLP分别为26.13±4.957cmH₂O、23.75±5.439cmH₂O和24.80±4.78cmH₂O（P=0.279）。Air-Q™、i-gel™和LMA-S™的首次置入成功率分别为80%、76%和92%（P=0.353）。Air-Q™、i-gel™和LMA-S™的置入时间分别为20.6±4.4秒、14.8±5.4秒和15.2±4.7秒（P=0.000）。Air-Q™的置入时间显著长于i-gel™（平均差值5.8秒，P<0.0001）和LMA-S™（平均差值5.4秒，P=0.0001）。三种装置的术后并发症相似。
我们得出结论，在气道解剖结构正常的成年患者的常规气道管理方面，Air-Q™、i-gel™和LMA-S™同样有效。
