Comparison of three supraglottic devices in anesthetised paralyzed children undergoing elective surgery

Context: The newest variation of the i-gel supraglottic airway is a pediatric version. Aims: This study was designed to investigate the usefulness of the size 2 i-gel compared with the ProSeal laryngeal mask airway (PLMA) and classic laryngeal mask airway (cLMA) of the same size in anesthetized, paralyzed children. Settings and design: A prospective, randomized, single-blinded study was conducted in a tertiary care teaching hospital. Methods: Ninety ASA grade I -II patients undergoing lower abdominal, inguinal and orthopedic surgery were included in this prospective study. The patients were randomly assigned to the i-gel, PLMA and cLMA groups (30 patients in each group). Size 2 supraglottic airway was inserted according to the assigned group. We assessed ease of insertion, hemodynamic data, oropharyngeal sealing pressure and postoperative complications. Results: There were no differences in the demographic and hemodynamic data among the three groups. The airway leak pressure of the i-gel group (27.1 +/- 2.6 cmH(2)O) was significantly higher than that of the PLMA group (22.73 +/- 1.2 cmH(2)O) and the cLMA group (23.63 +/- 2.3 cmH(2)O). The success rates for first attempt of insertion were similar among the three devices. There were no differences in the incidence of postoperative airway trauma, sore throat or hoarse cry in the three groups. Conclusions: Hemodynamic parameters, ease of insertion and postoperative complications were comparable among the i-gel, PLMA and cLMA groups, but airway sealing pressure was significantly higher in the i-gel group.