The AMBU® Aura-i™ Laryngeal Mask and LMA Supreme™: A Randomized Trial of Clinical Performance and Fibreoptic Positioning in Unparalysed, Anaesthetised Patients by Novices

Abstract

Introduction. Manikin studies' data cannot accurately be extrapolated to real-life scenarios and inherent differences in design and materials of newer products may affect their clinical performance. Methods. Hence, we compared the AMBU® Aura-i™ and LMA Supreme™ in this randomized trial involving 100 ASA 1-2 unparalysed anaesthetised patients undergoing minor gynaecological surgery. Investigators had <20 Aura-i insertions. Primary outcome was time to achieve effective ventilation and secondarily insertion parameters, oropharyngeal leak pressures (OLP), fibreoptic positioning, and pharyngeal morbidity. The position of the Ambu Aura-i was evaluated with the Ascope; the fiberoptic view of the glottis was scored on a five-point scale. Results. 43 (86%) AMBU Aura-i and 44 (88%) LMA Supremes were successfully inserted on first attempt (p = 0.59), with similar ease (p = 0.79), and comparable times to first capnogram, mean (SD) 18.2 (6.0) versus 17.3 (6.4) sec, p = 0.9. The Aura-i needed significantly less volume of air to inflate its cuff to 60 cmH2O on the manometer, 17.7 (3.5) versus 23.1 (4.4) mL, p < 0.001. Both devices exhibited similar OLP, Aura-i versus LMA Supreme, mean (SD) 28.8 (7.1) versus 27.3 (5.3) cmH2O, p = 0.24. There was no difference in ease of insertion or adjustment manoeuvres to aid ventilation. 90% of patients had good positioning of Aura-i on fibreoptic check, yielding a view of the vocal cords and epiglottis. In 5 patients (10%), the vocal cords were not seen, but ventilatory function was unaffected. Conclusions. The Aura-i handled well in novices hands, with comparable times to insert and establish ventilation, similar leak pressures, and successful first attempt insertion rates compared to the LMA Supreme.

A cohort evaluation of clinical use and performance characteristics of Ambu® AuraGain™: A prospective observational study

“…The average time (standard deviation [SD]) taken for device insertion was 17.32 (8.48) s. This was comparable to other SGDs[ 7 9 13 ] though faster insertion times have been also reported. [ 12 ] AG was inserted with moderate ( n = 11) or high resistance ( n = 1) in 12 patients which is half of what has previously reported in paediatric patients[ 7 ] or with AMBU ® Aura-i™.…”

“…The main finding of this study was that the AG can be an adequate ventilating device in terms of insertion and ventilating features, with an overall 100% insertion rate with timeframes comparable to other SGDs. [ 4 9 ] However, when assessed as conduit for intubation, it underperformed with a failure rate of 9%. To the best of our knowledge, there are no studies evaluating the utility of AG as a conduit for FOB-guided intubation.…”

“…[ 12 ] AG was inserted with moderate ( n = 11) or high resistance ( n = 1) in 12 patients which is half of what has previously reported in paediatric patients[ 7 ] or with AMBU ® Aura-i™. [ 9 ] While other authors have not commented on the ease of insertion of AG, they have reported a 100% success rate at first attempt, probably indicating that the device is easy to insert. [ 12 ] The ease of gastric tube insertion may indicate proper alignment of the device against the oesophageal inlet.…”

Neuroprotective and Antiamnesic Effects ofMitragyna inermisWilld (Rubiaceae) on Scopolamine-Induced Memory Impairment in Mice

“…That result was obtained by other authors [37–39], since scopolamine is a muscarinic cholinergic receptor antagonist which causes memory impairments in rodents especially in the processes of learning acquisition and short-term memory [40–42]. The fact that pretreatment with M. inermis for 8 days increased IR and decreased TL indicated the improvement in learning and memory in normal mice (without scopolamine).…”

Comparison of Fiberoptic-Guided Tracheal Intubation Through Intubating Laryngeal Mask Airway (ILMA) FastrachTM and Ambu® Aura-i™: A Randomized Clinical Study

“…In our study, the glottic view was reported as grade 1 in 80% of patients in group 1 and 92% of patients in group 2. Similarly, in a previous case study using Ambu Aura-i, the glottic view was reported as grade 1 in 88% of patients and grade 2 in 10% of patients, whereas in 2% of patients, grade 3 was observed [2]. Jagannathan et al in their study also used similar criteria for grading the glottic view [9].…”