Comparison of the Disposable Streamlined Liner of the Pharynx Airway and the Disposable I-gel in Anaesthetized, Paralyzed Adults: A Randomized Prospective Study

Abstract

Introduction. This study compared streamlined liner of the pharynx airway (SLIPA) and I-gel noninflatable, single-use, supraglottic airway device (SAD) performance in anesthetized, paralyzed adults. Methods. Eighty adults (ASA physical statuses I–III) who were undergoing elective procedures under general anesthesia with an SAD were enrolled in this prospective, randomized, single-blind study. Subjects were randomly and evenly assigned to the SLIPA or I-gel group for intraoperative airway management. Ease and number of insertions, insertion time, oropharyngeal sealing pressure, hemodynamic response, oxygen saturation (SpO2), end-tidal CO2 (EtCO2), and peri- and postoperative complications were examined. Results. The SLIPA and I-gel devices were successfully inserted in 100% and 95% of subjects, respectively. In two I-gel subjects (5%), ventilation was not possible after two attempts, but a size 55 SLIPA was successfully inserted in both cases. Forty-two and 38 patients were ultimately included in the SLIPA and I-gel groups, respectively. Insertion time was significantly shorter with the SLIPA (11.19 ± 3.03 s) than with the I-gel (15.05 ± 6.37 s, P = 0.003). Oropharyngeal sealing pressure was significantly higher in SLIPA (28.76 ± 3.11 cmH2O) than in I-gel (25.9 ± 3.65 cmH2O) subjects (P = 0.001). Blood staining occurred more frequently in SLIPA (n = 8, 19.0%) than in I-gel (n = 5, 13.2%) patients (P < 0.01). Heart rate, mean arterial blood pressure, SpO2, and EtCO2 were not significantly different between groups. Conclusion. Although blood staining incidence was higher, SLIPA insertion was easier and faster than I-gel insertion. The SLIPA provided better airway sealing pressure. Both devices had similar mechanical ventilation and oxygenation characteristics and comparable hemodynamic stability. Both noninflatable SADs are useful, but SLIPA rapid insertion and good airway sealing make it an effective alternative to the I-gel.

Insertion methods comparison for The Streamlined Liner of the Pharynx Airway in children by novice

“…Consistent with our hypothesis, the insertion success rate was significantly higher using the modified device compared to the unmodified device, indicating that the 120° bend facilitated successful SLIPA insertion by novice doctors. Previous studies have reported higher success rates with the conventional method than those obtained in our study, but they focused on adults and some were performed by experienced doctors , the success rate for SLIPA insertion into children using a device bent by 150° was 96%, but in that study, all insertion were performed by one experienced doctor.…”

“…Zhu et al reported an 18% incidence of blood stains on SLIPA after removal for a SLIPA bent 150°. In studies using an unmodified device, the blood stains on SLIPA after removal incidence ranged from 5.0 to 41.4% in adults . The low incidences of complications were mainly attributed to that each novice had only one chance to insert the device into a patient in our study, whereas a forementioned studies have allowed three insertion attempts.…”

“…For example, Zhu et al reported a 17.9 ± 5.2 s insertion time for pediatric‐sized SLIPA bent at 150°. In other reports using an unmodified device, insertion times have varied from 9.4 ± 4.1 s to 11.19 ± 3.03 s . In a study reported by Miller et al, 90% of SLIPAs were inserted within 15 s, and 88% were inserted within this time frame in a study reported by Lange et al.…”

Comparison of I-gel with Baska Mask Airway for Controlled Ventilation in Obese Patients Undergoing Ambulatory Surgery: A Prospective Randomized Trial

“…The ease of SAD insertion was qualitatively evaluated using the following 4-point scale [5,12]. A score 1 means easy insertion on first attempt with no need for adjustment, a score 2 is considered in case of slight difficult insertion on first attempt with at least one adjustment maneuver.…”

“…The Oropharyngeal sealing pressure (OSP) was measured once an effective airway had been achieved using a fresh gas flow rate of 5 L/min, closure of the adjustable pressure limiting valve of the anesthetic circuit and recording the pressure when gas was heard leaking around the device [5,13]. Sore throat also was assessed as present or absent one hour after the operation and the patient was asked about the presence of dysphonia one hour and 24 hours postoperative.…”