Comparative evaluation of self-pressurized Air-Q® and Proseal™ LMA® in patients undergoing elective surgery under general anaesthesia: A randomized clinical trial

Abstract

Background and Aims: Intra-cuff pressure of Air-Q self-pressurized laryngeal airways (Air-Q SP) balances airway pressure and adapts to patient’s pharyngeal and periglottic structures, thus improves oropharyngeal leak pressure (OLP).This study was performed to compare efficacy of Air-Q SP with Proseal laryngeal mask airway (PLMA) in patients undergoing elective surgery. Material and Methods: The study design was prospective, randomized and controlled. Ninety patients were randomly assigned to Air-Q SP or PLMA group. All patients were premedicated and shifted to operation theatre. Monitoring was instituted. After securing IV-line, induction with inj. Morphine + Propofol, relaxation with inj. Vecuronium was done. Supraglottic was inserted according to group allocation. Outcome measures were OLP, fibreoptic view of larynx, success rate, device insertion parameters, haemodynamic and respiratory parameters and post-operative laryngopharyngeal complications. Neostigmine + glycopyrrolate were given, device was extubated. Results: All supraglottic airway devices (SADs) were successfully placed in two attempts. The mean initial OLP, OLP at 10 minutes, and device insertion time were significantly lower in Air-Q SP group. Fiber-optic laryngeal view grading was significantly better with Air-Q SP. No significant difference was observed with respect to rate of successful insertion in first attempt, ease of insertion, and manipulations required. The hemodynamic/respiratory parameters and post-operative sore throat in the two both groups were similar. Conclusions: Proseal LMA has a higher OLP than Air-Q SP but average insertion time was better, and fiber-optic grading of laryngeal view was shorter with Air-Q SP. However, Air-Q SP and Proseal LMA were both effective for lung ventilation.

Comparison between Air-Q Self Pressurized Airway Device with Blocker and Proseal Laryngeal Mask Airway in anesthetized paralyzed adult female patients undergoing elective gynecological operations

“…The Air-Q family has included the standard Air-Q (Air-Q ILA), Air-Q Blocker and Air-Q SP [ 26 – 33 ]. The SP Blocker is an enhanced disposable PVC-made version of the standard Air-Q representing a revolution in SADs design [ 5 , 34 ]. The PLMA is a reusable silicone-made SAD that can provide a better glottis seal permitting use of high airway pressures without leak [ 35 – 37 ].…”

“…This tube is a large-bore, multi-orifice drain tube that is designed to pass through the guide channel for accessing and suctioning the posterior pharynx in addition to suctioning, venting, and blocking the upper esophagus. SP Blocker size selection is dependent on the patient’s weight (size 2.5: 30–50 kg; size 3.5: 50–70 kg; size 4.5: 70–100 kg) [ 5 ].…”