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

Background:The The Air-Q Self Pressurized Airway Device with Blocker (SP Blocker) was compared to the Proseal Laryngeal Mask Airway (PLMA) during positive pressure ventilation regarding the primary outcome (oropharyngeal leak pressure [OLP]), secondary outcomes (peak inspiratory pressure [PIP], inspired tidal volume [ITV], expired tidal volume [ETV], leak volume [LV] and leak fraction [LF]), insertion time, ventilation score, fiber-optic glottis view score, and postoperative laryngopharyngeal parameters (LPM). Methods: Adult healthy female patients scheduled for elective gynecological laparotomies under general anesthesia using controlled mechanical ventilation were recruited to a prospective randomized comparative clinical trial. Exclusion criteria were body mass index (BMI) >= 35 kg m(-2), , El-Ganzouri score >= 5, upper airway problems, hiatus hernia or pregnancy. Patients were classified into an SP Blocker group (n n = 75) and a PLMA group (n n = 75). Primary and secondary outcomes were assessed initially and at fixed time points after successful insertion of devices. Results: Initially after successful device insertion: the SP Blocker group showed statistically significant higher mean OLP (cmH(2)O) ) (29.46 +/- 2.11 vs. 28.06 +/- 1.83 respectively; 95% CI: -2.037 to -0.76, P < 0.0001), lower mean PIP (cmH(2)O)) (15.49 +/- 0.61 vs. 17.78 +/- 1.04 respectively; 95% CI: 2.02 to 2.56, P < 0.0001), higher mean ITV (mL) (411 +/- 30 vs. 403 +/- 15 respectively; 95% CI: -15.65 to -0.347, P = 0.041), higher mean ETV (mL) (389 +/- 12 vs. 354 +/- 11 respectively; 95% CI: -38.72 to -31.29, P < 0.0001), lower mean LV (mL) (22 +/- 18 vs. 49 +/- 10 respectively; 95% CI: 22.3 to 31.7, P < 0.0001) and lower mean LF (%) (5 +/- 2.04 vs. 12 +/- 6.8 respectively; 95% CI: 5.38 to 8.62, P < 0.0001) than the PLMA group. Mean insertion time (seconds) was shorter in the SP Blocker group than the PLMA group (16.39 +/- 2.81 vs. 18.63 +/- 3.44 respectively; 95% CI: 1.23 to 3.25, P < 0.0001). The SP Blocker group offered a better fiber-optic glottis view score than the PLMA group without differences concerning ventilation score and LPM. Conclusions: SP Blocker provided as safe anesthesia during controlled mechanical ventilation as PLMA.