Effect of the new non-inflatable laryngeal mask GMA-Tulip on airway management for lateral total hip arthroplasty in geriatric patients: a randomized controlled trial

Background The supraglottic airway device (SAD) is nowadays widely used as a ventilation device. The GMA-Tulip is a new non-inflatable SAD used to establish short-term artificial airway for general anesthesia or cardiopulmonary resuscitation. In the present study, we compare the clinical performance of the GMA-Tulip and the LMA Supreme for lateral total hip arthroplasty in geriatric patients. Methods In 70 anesthetized and paralyzed adult patients, the GMA-Tulip (n = 35) or the LMA Supreme (n = 35) was inserted. The primary outcome was oropharyngeal leak pressure (OLP). The secondary outcomes included the peak airway pressure (PAP), insertion time, insert resistance, number of insertion attempt and manipulations, glottic exposure grading, and incidence of perioperative complications. Results The GMA group had a significantly higher OLP and lower PAP at the 4 measurement points than did the Supreme group (P < 0.05). Compared with that in the supine position, the OLP of the two groups was significantly lower in the lateral position (P < 0.05). The LMA Supreme had a longer insert time (36(32,39) vs. 18(15,22) sec; P < 0.001) and was inserted more difficultly (P < 0.05). The sore throat scores one hour after surgery at the LMA Supreme was higher than that at the GMA-Tulip (P < 0.05), but the incidence of blood staining was not different between the two groups (P = 0.106). Conclusions The GMA-Tulip and LMA Supreme both provided considerable ventilation efficiency during lateral total hip arthroplasty in geriatric patients. Our data showed that new non-inflatable laryngeal mask GMA-Tulip has a higher OLP and demonstrated a shorter time to successful placement and a lower sore throat score one hour after surgery compared with the LMA Supreme.