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Second-generation supraglottic airway devices i-gel (Intersurgical Ltd) and LMA ProSeal (Teleflex Inc) are designed for a superior airway seal with a high success rate in adults. This study compared the efficacy of i-gel and LMA ProSeal (sizes 1, 1.5, and 2) as an airway device in a pediatric population, especially infants. The study included 163 ASA class 1 and 2 children, aged up to 10 years and weighing 2 to 25 kg, undergoing elective surgeries lasting less than 1 hour under general anesthesia on spontaneous respiration. Participants were randomly assigned to 2 groups: i-gel and LMA ProSeal. With each device, the ease of insertion, time of insertion, manipulations required for placement of the device, and oropharyngeal leak pressure were recorded. A lubricated gastric tube of the recommended size was passed through each device, and ease of insertion was noted. At the end of surgery, the device was removed and complications were noted, including laryngospasm, breath holding, and bloodstains. Mann-Whitney U test and x^sup 2^ tests were used to compare collected data.
Both devices were found to be comparable in effectively securing the airway in children, even in infants. The insertion time was significantly faster with i-gel.
Keywords: i-gel, LMA ProSeal, pediatric, supraglottic airway devices.
Supraglottic airway devices have been demonstrated in pediatric anesthesia by Lopez-Gil et al1 to adequately secure the airway without any major intraoperative morbidity for spontaneous and controlled ventilation. The latest additions to the family of supraglottic airway devices are the second-generation devices suitable for children. The classic laryngeal mask provides a moderate pharyngeal seal, which causes gastric insufflation associated with an increase in abdominal circumference during positive pressure ventilation.2 This predisposes to gastric regurgitation and pulmonary aspiration. It also leads to diaphragmatic compression, impeding spontaneous ventilation. The i-gel and the LMA ProSeal, being second-generation devices, have a better safety profile because they have been designed to have a superior esophageal and pharyngeal seal and hence minimal gastric insufflation during positive pressure ventilation. They also have a gastric drain tube to provide protection against aspiration and to aid gastric decompression.3-6
The i-gel is an innovative supraglottic airway device with a noninflatable cuffof thermoplastic elastomer. The cuffcreates a good airway seal, as it is designed to mirror the pharyngeal, laryngeal, and...