Gnana Laryngeal Airway in Clinical Practice: A Prospective Observational Study

Objective: The Gnana Laryngeal Airway (GLA) device, a novel supraglottic, airway device, is similar to the LMA-Classic in basic design, but with an additional suction port on the convex portion of the laryngeal mask to remove the saliva. We evaluated the GLA device in terms of ease and time to insertion, the number of attempts, oropharyngeal leak pressure (OLP), cornet placement, and complications in adult patients undergoing elective surgical procedures. Methods: After general anaesthesia, the GLA device was inserted in ASA Class I-H consecutive patients aged 18-60 years, who were scheduled for elective surgeries lasting <2h. An independent observer noted (1) 10 consecutive successful CAA device insertions, all on the first attempt: (2) 10 consecutive device insertions, each <20 second in duration; and (3) 10 consecutive patients with the mean leak <10%. The criteria were fulfilled in 50 consecutive patients. Results: In 72% of patients, the CAA device was successfully placed on the first attempt and was effortless in 64%. Between the first 10 and last 10 consecutive patients of the total 50, the ease-of-insertion grade progressively decreased (mean +/- standard deviation [SD]: 2.80 +/- 0.25 to 1.30 +/- 0.15, p<0.0001) and so did insertion time in seconds (28.70 +/- 1.87 to 14.20 +/- 0.79, p<0.0001). The post-insertion, OLP and airway compliance progressively increased, while the cuff inflation volume, peak airway pressure and airway resistance progressively decreased, along with minimal side effects and malposition. Conclusion: The GLA device insertion became progressively easier and faster; thus, such a device is promising and warrants further clinical evaluation.