Comparison of Proseal Laryngeal Mask Airway (Proseal LMA™) with I-Gel by Fireoptic View of Glottic Aperture in Anaesthetised Adult Patients

• Author Details:   
• Anand Kuppusamy
• Jayakar Guruswamy
• Karunanithi Parasakthi

---

Background: The i-gel, a new supraglottic airway device, has been touted to have acceptable airway seal pressure and better ventilatory parameters than Proseal laryngeal mask airway (PLMA) in adults. We propose to test this hypothesis objectively, by comparing fibreoptic grading of positioning of the above airways in adult patients.
Methods: Ninety two adult patients undergoing minor surgeries were randomly assigned to either the PLMA or the i-gel group for airway management. Fibreoptic bronchoscope was inserted through airway tube and glottis view was graded according to established scoring system. Other parameters noted include effective airway time, failed insertions, oropharyngeal leak pressure, ease of gastric tube insertion, airway morbidity. The incidence of sore throat, dysphonia, dysphagia was assessed after 24 hours.
Results: There was no statistical difference between both groups with respect to effective airway time, success rates at first attempt of insertion, ease of gastric tube insertion, airway trauma during insertion and postoperative airway morbidity. Proseal laryngeal mask airway was placed better than i-gel as confirmed by fibreoptic scoring of glottic view. Oropharyngeal leak pressure was better with PLMA group than i-gel.
Conclusion: We conclude that PLMA was placed better than i-gel as confirmed by better fibreoptic scores and had higher oropharyngeal leak pressure.

Keywords: Proseal laryngeal mask airway, Fibreoptic view of glottis, igel, Oropharyngeal leak pressure