Comparison of the clinical performance of I-Gel and ambu aura gain-supra-glottic airway devices in paediatric patients under controlled ventilation

Abstract

: I-Gel and Ambu Aura Gain are two novel second generation supra-glottic airway devices available for airway management and can be used safely and effectively in paediatric patients under controlled ventilation with adequate airway seal. The aim of our study was to compare efficacy of I-Gel and Ambu Aura Gain in providing safe and adequate airway seal in paediatric patients under controlled ventilation. A prospective, randomized, single blind clinical study was carried out on total 60 paediatric patients with ASA grade I & II, 3-10 years age, undergoing surgery under general anaesthesia. The patients were randomly assigned into Group I (I-Gel) (n=30) and Group-A (Ambu Aura Gain) (n=30) using randomizer software. I-Gel was inserted using “finger technique” and Ambu Aura Gain with simple insertion technique. We assessed effective airway insertion time, time required for insertion of the device, ease and number of attempts for airway and gastric tube insertion, oropharyngeal leak pressure, haemodynamic parameters and complications. Statistical analysis was done using the MedCalc software, student’s paired t- test, unpaired t-test and chi-square test. Effective airway insertion time (p=0.1671), ease and numer of airway insertion attempts were comparable amongst both groups. Oropharyngeal leak pressure was significantly higher in group I (22.366±1.4735 of H2O) than in group A (20.8±1.01 cm of H2O), p value = 0.0001. Airway seal of Ambu Aura Gain is lesser compared to I-Gel. I-Gel can be used with better safety and efficacy for controlled ventilation in paediatric patients. I-Gel provides higher oropharyngeal seal pressure, which gives higher safety against risk of aspiration and air leak than Ambu Aura Gain, yet oropharyngeal seal pressure of Ambu Aura Gain is adequate that it allows its use during controlled ventilation under general anaesthesia. Hence, both devices can be used alternatively.