Comparison of Laryngeal Mask Airway Protector versus Laryngeal Mask Airway Blockbuster in Patients undergoing General Anaesthesia: A Randomised Control Study

Securing airway is of critical importance in patients undergoing surgeries and its maintenance is essential for stability of the patient during surgery. The airway management serves as the foundation on which efficacy and safety of anesthesia practice are built. Laryngeal Mask Airway (LMA) is an important tool used for maintenance of airway. Such devices revolutionized the practice which were introduced by Archie Brain and it was less stressful than tracheal intubation to the patients. It was as safe as using a facemask and airway. These are commonly employed in anaesthetic, critical care, and emergency scenarios for managing the airway. It also excels in managing challenging airways. It offers advantage of avoiding endotracheal intubation and provides a shorter insertion time as well as it has lower incidence of post-operative pharyngeal pain, and better hemodynamic stability during induction and emergence.

The mechanism of action of LMAs is through the creation of a low-pressure seal around the laryngeal inlet which permits positive pressure ventilation. This design minimizes the need for neuromuscular blockade and allows for a smoother airway management process, particularly in cases where intubation may be challenging or unnecessary. Over the years, various LMA devices have been developed. Each with specific features are designed to improve its ease of use, safety, and effectiveness. These range from the classic LMA, flexible LMA, to more recent LMAs such as the LMA Supreme, LMA ProSeal, LMA protector and last but not the least LMA Blockbuster.

Among these, One notable device in this group is the LMA Protector, which stands out due to its advanced features that aim to improve patient safety and make it easier to insert. The LMA Protector, with its dual gastric access channels and cuff pressure monitoring capabilities, represents a significant advancement in LMA technology. The device is designed to offer superior protection against aspiration, a critical consideration in anesthesia management. However, despite its advantages, the LMA Protector is not without challenges. Issues such as the need for precise placement, potential for increased costs, and the requirement for training to optimize its use are notable concerns.

A revolutionary second generation LMA known as the Blockbuster LMA developed by Prof. Ming Tian in 2012. The LMA BlockBuster represents another significant advancement in airway management technology. The  LMA BlockBuster incorporates features that address some of the limitations observed in earlier LMA designs. Its peculiarities, such as enhanced seal pressure capabilities and improved ease of insertion, contributed to its growing popularity. The LMA BlockBuster’s design focuses on providing a high degree of airway security and ventilation efficiency.

Comparing the LMA Protector and LMA BlockBuster reveals significant differences that influence their use in anaesthesiology. The LMA Protector’s dual-channel design offers unique advantages in managing gastric contents and monitoring cuff pressure, potentially reducing the risk of aspiration. In contrast, the LMA BlockBuster, with its focus on ease of insertion and high seal pressures, may be preferred in scenarios where rapid and reliable airway management is critical. The choice between these devices often depends on specific patient conditions, surgical requirements, and the anaesthesiologist’s expertise and preference.

Despite the advancements and the availability of various LMA devices, there remains a knowledge gap in the literature concerning the comparative effectiveness, safety, and applicability of the LMA Protector versus the LMA BlockBuster. Despite the extensive research being undertaken on the topic of various LMAs, the comparison between LMA Protector and LMA BlockBuster remains scarce. There is hardly any study that has come up with such comparison.  There is a need for a comprehensive and well-designed comparative study addressing these two LMAs.

With this background we undertook this study to compare the safety and efficacy between LMA Protector and LMA Blockbuster in providing airway management for patients undergoing surgeries under general anesthesia.