Comparison of Clinical Efficacy of Ambu AuraGain and Laryngeal Mask Airway Proseal Inflated to 40 cmH2O with I-Gel for Ventilation in Paediatric Patients Undergoing Elective Surgery Under General Anaesthesia

Background The intracuff pressure of supraglottic devices in children should be maintained at 40 cmH2O. We compared the oropharyngeal leak pressures (OLP) of the LMA Proseal, AAG, and I-gel. Research design and Methods After obtaining IRB approval, 120 children (aged 1–10 years) were randomly divided into three groups to undergo elective procedures under general anesthesia: Ambu AuraGain (Group A, N=40), I-gel (Group I, N=40), or LMA Proseal (Group P, N=40). We compared OLP post-device insertion at 5 and 30 min, insertion characteristics, and Brimacombe scores. Results The mean (SD) OLP was significantly higher with I-gel as compared to the AAG and LMA Proseal at 5 min [28.30(1.77) vs. 24.38(1.90) vs. 24.30(2.45); p<0.001] and 30 min post device insertion [28.98(1.27) vs. 24.77(1.83) vs. 24.30(2.45); p<0.001]. The median (IQR) time to achieve effective ventilation was significantly shorter in group-I [16s(15-16.25) vs. 18.5s(18-20) vs. 18s(17.75-19), respectively p<0.001]. The anatomical alignment of the device to the glottic opening was significantly better in groups A and P (p<0.001). First-attempt success, ease of device insertion, and gastric catheter insertion were similar in all patients. Conclusion All three devices provided effective ventilation in pediatric patients undergoing elective surgery under general anesthesia. The I-gel was better than the AAG and LMA Proseal in terms of higher OLP. Trial registration CTRI/2023/10/059077[Registered on: 25/10/2023].