Comparison of the i-gel™ with the AuraGain™ laryngeal mask airways in patients with a simulated cervical immobilization: a randomized controlled trial.

BACKGROUND

The use of second generation supraglottic airway devices is recommended for airway rescue in failed tracheal intubation. This study was performed to compare the clinical performance of the i-gel™ with that of the AuraGain™ in patients with simulated cervical immobilization.

METHODS

We conducted a prospective, randomized controlled trial in 104 patients undergoing general anesthesia from June to September 2018 at the Seoul National University Hospital. Patients were randomly allocated to receive either the i-gel™ or the AuraGain™ device. A difficult airway was simulated using a cervical collar limiting the mouth opening and neck movement. The primary outcome was the initial oropharyngeal leak pressure.

RESULTS

The rate of successful insertion at the first attempt was 92.3% for the i-gel™ and 86% for the AuraGain™. There were no significant differences in the initial and 5-min oropharyngeal leak pressures between the i-gel™ and the AuraGain™ (21±4 vs. 22±5 cmH2O, P=0.229; and 22±5 vs. 23±5 cmH2O, P=0.308, respectively). The time to successful device insertion was shorter (20 [16-23] vs. 25 [20-41] s, P<0.001) and device insertion was easier (P<0.001) in the i-gel™ group than in the AuraGain™ group. The blood staining of the device was more frequently observed in the AuraGain™ (3 [5.8%] vs. 12 [23.5%] patients, P=0.003).

CONCLUSIONS

The i-gel™ and the AuraGain™ showed comparable oropharyngeal leak pressures and success rates in the first attempt in patients with simulated cervical immobilization. However, the i-gel™ was easier to insert and required less time for insertion than the AuraGain™.