A randomized controlled trial to compare the BlockBusterTM Laryngeal Mask with LMA® ProtectorTM Airway as a conduit for blind endotracheal intubation in patients undergoing elective surgery under general anaesthesia

The supraglottic airways (SGA) are frequently used as the primary device to secure the airway in elective surgeries as well as in recognized difficult airway cases. The SGA can also be used as a rescue device, for restoring oxygenation and ventilation while allowing time to prepare for other airway manoeuvres. The SGAs can also be used as a conduit for tracheal intubation, this technique has been recommended by the Difficult Airway Society (DAS) for difficult airway management . Intubation through these devices is also recommended in the ‘All India Difficult Airway Association’ guidelines . It is also recommended that the intubation through SGAs be done under fibreoptic bronchoscope (FOB) guidance. However, this requires the availability of a FOB and expertise in its use, which may not be possible many times, particularly in the emergency situations managed by residents. Therefore, the new SGAs designed to facilitate blind tracheal intubation are gaining popularity as a bridge connecting ventilation and intubation in all genres of patients.

The BlockBusterâ„¢Laryngeal Mask, invented by professor Ming Tian in 2012 has been recently launched in the Indian market and is designed primarily to provide a green channel for the smooth passage of cuffed tracheal tube for blind tracheal intubation .

The Laryngeal Mask Airway® (LMA) Protectorâ„¢ Airway (Teleflex Medical Europe, Westmeath, Ireland) was first used in clinical practice in 2015. It is made of medical-grade silicone with two large volume gastric drainage channels and integrated with a cuff pressure indicator, the Cuff Pilotâ„¢ . The easy insertion is attributed to its fixed-curved structure, and its wide internal airway lumen diameter (up to 13 mm) which allows flexibility and thereby enhancing its use as an intubation conduit.

Blind intubation through an SGA can be lifesaving in cases of difficult airway. The technique should however be perfected first in patients with normal airways. Considering the limited availability of FOB in emergency situations, the new SGAs designed to facilitate blind tracheal intubation like the BlockBusterTM Laryngeal Mask and LMA® ProtectorTM Airway are gaining popularity. There is very limited published data comparing the first pass success rate of blind endotracheal intubation through the BlockBusterTM Laryngeal Mask with LMA® ProtectorTM Airway in patients undergoing elective surgery under general anaesthesia. Therefore, we planned this study to compare the first pass success rate of blind endotracheal intubation through both these devices. The ease, number of attempts and time taken for the placement of SGA, number of attempts, manoeuvres required and time taken to intubate through the SGA and complications will also be compared using the BlockBusterTM Laryngeal Mask with LMA® ProtectorTM Airway.