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A Comparison of Ambu® AuraGain™ Laryngeal Mask Airway and I-gel in Adult

Not Applicable
Completed
Conditions
Laryngeal Mask
Intubation; Difficult or Failed
Interventions
Device: Ambu® AuraGain™
Device: I-gel
Registration Number
NCT03544749
Lead Sponsor
Seoul National University Hospital
Brief Summary

The supraglottic airway device(SAD), as an alternative to the endotracheal tube is inserted into the oral cavity and seals the upper esophagus and the surrounding tissue, effectively securing airway. SAD has evolved in recent years to increase efficiency and secure safety. The recently developed Ambu® AuraGain™ is a second-generation SAD with a built-in gastric port and is designed to be fitted well in the larynx and oral cavity after insertion because the shaft is bent at an angle of 90 degrees and has an inflatable cuff.

In a previous study, Ambu® AuraGain™ showed a higher sealing pressure and better fibreoptic finding compared to LMA Supreme in laparoscopic surgery.

On the other hand, I-gel and Ambu® AuraGain™, both of the second-generation SAD, show comparatively excellent performance according to the results of previous studies. However, there are no studies comparing the characteristics of two airway devices in adults.

The purpose of this study is to compare the performance of I-gel and Ambu® AuraGain™ to make a difficult airway-like situation using cervical collar for adult patients receiving mechanical ventilation under general anesthesia.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
104
Inclusion Criteria
  • Patients who are undergoing surgery under general anesthesia where supraglottic airway management will be appropriate.
Exclusion Criteria
  • Body mass index > 35 kg/m2
  • High risk of regurgitation (hiatus hernia, gastro-esophageal reflux disease, non-fasting status)
  • Criteria for difficult airway
  • Patients with cervical disease or previous cervical spine surgery

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Ambu® AuraGain™ groupAmbu® AuraGain™-
I-gel groupI-gel-
Primary Outcome Measures
NameTimeMethod
Oropharyngeal leak pressureAt an average of 30 seconds after insertion of laryngeal mask airway

Oropharyngeal leak pressure is measured by closing the expiratory valve and administering fresh gas flow of 6 L/min, until the equilibrium pressure is reached (to a maximum of 40 cm of H2O).

Secondary Outcome Measures
NameTimeMethod
Oropharyngeal leak pressureAt 5 minute after insertion of laryngeal mask airway

Oropharyngeal leak pressure is measured by closing the expiratory valve and administering fresh gas flow of 6 L/min, until the equilibrium pressure is reached (to a maximum of 40 cm of H2O).

The time for successful gastric tube placementDuring induction of anesthesia, an average of 5 minutes

The insertion time is measured from first handling of the gastric tube to confirmation of its position in the stomach by aspiration of gastric fluid.

The number of airway maneuvers required to maintain airway patencyDuring the surgery, an average of 2 hours after anesthesia induction

Airway maneuvers required to maintain airway patency, including jaw thrust, head/neck extension and/or device adjustments such as advancement/withdrawal of device, and alterations to cuff volume.

Overall success rateDuring induction of anesthesia, an average of 60 seconds

Successful insertion of laryngeal mask airway in a maximum of three attempts

The time for successful insertion of the deviceDuring induction of anesthesia, an average of 60 seconds

The total time is measured from the removal of the face mask until bilateral chest rise with the first capnogram upstroke.

The grade of fiberoptic bronchoscopic viewDuring induction of anesthesia, an average of 5 minutes

The fiberoptic bronchoscopic view is defined as Grade 1, larynx only seen; Grade 2, larynx and epiglottis posterior surface seen; Grade 3, larynx, and epiglottis tip or anterior surface seen-visual obstruction of epiglottis to larynx: \< 50%; Grade 4, epiglottis down-folded, and its anterior surface seen-visual obstruction of epiglottis to larynx: \> 50%; Grade 5, epiglottis downfolded and larynx cannot be seen directly.

Postoperative complicationsAn average of 2 hours after extubation

Postoperative complications including sore throat, hoarseness/dysphonia, jaw, neck or ear pain, persistent cough, tachypnea, stridor, hypoxia (SpO2 \< 90%), nausea and vomiting.

The number of attempts at insertion of deviceDuring induction of anesthesia, an average of 60 seconds

The number of attempts for successful insertion of laryngeal mask airway

The ease of gastric tube placementDuring induction of anesthesia, an average of 5 minutes

The ease of gastric tube placement was graded on a subjective scale (1 = easy, 2 = difficult, 3 = unable to pass)

Intraoperative complicationsDuring the surgery, an average of 2 hours after anesthesia induction

Intraoperative complications including coughing, laryngospasm, bronchospasm, hypoxia (SpO2 \< 90%), regurgitation, aspiration, blood staining of the device.

Success rate in first attemptDuring induction of anesthesia, an average of 60 seconds

Successful insertion of laryngeal mask airway in a first attempt

The ease of insertion of deviceDuring induction of anesthesia, an average of 60 seconds

The ease of placement was assessed using a subjective scale of 1-4 (1= no resistance, 2 = moderate resistance, 3 = high resistance, 4 = inability to place the device)

Peak inspiratory pressureAt 5 minute after insertion of laryngeal mask airway

Peak inspiratory pressure is recorded from mechanical ventilator.

The type of airway maneuvers required to maintain airway patencyDuring the surgery, an average of 2 hours after anesthesia induction

Airway maneuvers required to maintain airway patency, including jaw thrust, head/neck extension and/or device adjustments such as advancement/withdrawal of device, and alterations to cuff volume.

Trial Locations

Locations (1)

Seoul National University Hospital

🇰🇷

Seoul, Korea, Republic of

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