Evaluation of the New SingularityTM Air versus Ambu® Aura GainTM: A Randomized, Crossover Mannequin Study

Abstract

Background: This randomised crossover mannequin study aimed to compare the insertion time for the newly developed SingularityTM Air and the Ambu® AuraGainTM. The SingularityTM Air includes a bendable tube in order to allow optimal passform. Methods: Fifty anaesthetists with a minimum of 100 supraglottic airway device insertions were recruited and randomly assigned to start either with the SingularityTM Air or with the Ambu® AuraGainTM. Participants watched a tutorial video the day before the assessment and received a standardized introduction immediately before the assessment. The primary outcome was the time for successful insertion. Secondary parameters were the overall insertion success rate, the numbers of insertion attempts (maximum three), the glottic view through a flexible bronchoscope, and the success rate for gastric tube insertion. Results: Fifty participants were eventually recruited and randomly assigned to insert both devices according to the randomization. The insertion time was 24 s for SingularityTM Air as compared to 20 s for Ambu® AuraGainTM (p < 0.001). Overall insertion rate was 92% for the SingularityTM Air as compared to 100% for the Ambu® AuraGainTM (p could not be derived as one variable is a constant). The primary insertion success rate was better for the Ambu® AuraGainTM than for the SingularityTM Air (94% versus 68%; p: 0.002, respectively). Conclusion: The time for successful insertion and the insertion success rate for the newly developed SingularityTM Air is inferior to that for the Ambu® AuraGainTM.

Prospective Clinical Evaluation of the Singularity™ Air Laryngeal Mask in Adult Patients

“…Although the time-to-successful ventilation was within the range of other devices when, for example, using a guided insertion technique or for military novices inserting laryngeal masks, the Singularity™ Air's design presents some challenges. Gasteiger et al attributed the difficulty of inserting the Singularity™ Air to the soft tip of the device, resulting in a predetermined kinking point [8]. In that mannequin study, the overall success rate for insertion and sufficient ventilation was 92%, slightly lower than our findings with human patients.…”

“…The Singularity™ Air laryngeal mask (Singularity AG, Maur/Zurich, Switzerland; Figure 1) expands on the second generation's design by including a dial to adjust the shaft angle after insertion, which ought to improve the fitting to the patient's airway and thereby airway sealing. The Singularity™ Air laryngeal mask's performance has been measured on mannequins only [8]. Our study's primary aim was to evaluate the mask's effectiveness under clinical conditions by measuring the oropharyngeal leak pressure, and the secondary endpoints were to determine the ease of insertion and patient comfort.…”