Anestesia e Pesquisa Clínica
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A Randomised Comparison of the Supreme Laryngeal Mask Airway with the i-gel During Anaesthesia

Fenner LB, Handel J, Srivastava R, Nolan J, Seller C and TM Cook

Objective: The i-gel and LMA Supreme are second-generation supraglottic airways. We performed a comparison of the two with the primary endpoint of first insertion success by experienced anaesthetists. Methods: With Ethics Committee approval, patients were randomised to insertion of either device. Anaesthesia was maintained with sevoflurane and patients were not paralysed. Data was collected on insertion, oropharyngeal leak pressure, fibreoptic view via both airway and drain tube, adequacy of controlled ventilation, clinicians’ subjective assessments of airway performance and complications at each stage from insertion to the first post-operative day.

Results: Data from 97 patients were analysed. The primary outcome was insertion success on first attempt, which was 78% for i-gel and 87% with SLMA (p=0.4). There were no statistically significant differences between the two devices’ performances: >92% overall insertion success, >98% of airways rated “good” after insertion, >90% optimal ventilation, minimal complication rates during insertion, maintenance and removal, and low rates of postoperative sequelae, >90% of which were mild. Both devices performed safely, with no episodes of aspiration or long term sequelae.

Conclusions: We have conducted a rigorous comparison of the i-gel and SLMA in a European population receiving sevoflurane anaesthesia, without muscle relaxation. Performance of the two devices is very similar.