A prospective, randomized comparison of the LMA-protector™ and i-gel™ in paralyzed, anesthetized patients

Jee-Eun Chang, Hyerim Kim, Jung-Man Lee, Seong-Won Min, Dongwook Won, Kwanghoon Jun, Jin-Young Hwang, Jee-Eun Chang, Hyerim Kim, Jung-Man Lee, Seong-Won Min, Dongwook Won, Kwanghoon Jun, Jin-Young Hwang

Abstract

Background: In the present study, we compare the LMA-Protector™ and the i-gel™ in terms of adequacy of the airway seal, insertion time, ease and accuracy of insertion, and the incidence of postoperative sore throat.

Methods: In 110 anesthetized and paralyzed adult patients, the i-gel™ (n = 55) or the LMA-Protector™ (n = 55) was inserted. The primary outcome was airway leak pressure. The secondary outcomes included the first-attempt success rate, insertion time, ease and accuracy of the device insertion, ease of gastric tube placement, blood staining on the device after removal, and incidence and severity of postoperative sore throat.

Results: The airway leak pressure was higher with the LMA-Protector™ than with the i-gel™ (31 [7] cmH2O vs. 27 [6] cmH2O, respectively; P = 0.016). Insertion time was longer with the LMA-Protector™ than with the i-gel™ (27 [16] sec vs. 19 [16] sec, respectively, P < 0.001), but ease of insertion and the first-attempt success rate were not different between the two groups. The LMA-Protector™ provided a worse fiberoptic view of the vocal cords and more difficult gastric tube insertion than the i-gel™ (both P < 0.001). Blood staining on the device was more frequent with the LMA-Protector™ than with the i-gel™ (P = 0.033). The incidence and severity of postoperative sore throat were not different between the two groups.

Conclusion: The LMA-Protector™ provided a better airway sealing effect than the i-gel™. However, it required a longer insertion time, provided a worse fiberoptic view of the vocal cords, and caused more mucosal injury compared to the i-gel™.

Trial registration: ClinicalTrials.gov (NCT03078517). Registered prior to patient enrollment, Date of registration: Mar 13, 2017.

Keywords: Airway sealing; I-gel; LMA-protector™.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
(a) LMA-Protector™. a, male suction port; b, female drainage port; c, integrated Cuff Pilot™ (b) Cuff of the i-gel™ and LMA-Protector™ (c) Distal orifice of gastric channel of the i-gel™ and LMA-Protector™. Size 4 LMA-Protector™ and i-gel™ were used for this photograph
Fig. 2
Fig. 2
Study flowchart

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