Comparative Evaluation of Clinical Efficacy of Ambu AuraGain™ Disposable Laryngeal Mask with i-gel™ for ventilation in paediatric patients undergoing elective surgery under general anaesthesia
DOI:
https://doi.org/10.25751/rspa.36553Palavras-chave:
Supraglottic airway device, Airway, Paediatric, General Anaesthesia, Elective surgical procedure, Positive pressure ventilationResumo
Objective: This prospective interventional randomised single-blinded comparative study aimed to evaluate the clinical efficacy of Ambu AuraGain™ and i-gel™ as supraglottic airway devices for controlled ventilation in paediatric patients undergoing elective surgical procedures under general anaesthesia.
Methods: The study included 80 children aged between 2 and 10 years, weighing between 10 to 30 kg, and classified as ASA Physical Status I and II. Children with anticipated difficult airways, high risk of aspiration, or respiratory tract infections were excluded. Participants were randomly assigned to either Group A (Ambu AuraGain™) or Group I (i-gel™). The primary outcome was the measurement of oropharyngeal seal pressure (OSP) at 5 and 10 minutes post device insertion. Secondary outcomes involved evaluating insertion characteristics, fiberoptic bronchoscope views, ventilatory parameters, hemodynamic variables, and complications.
Results: The mean OSP was significantly higher in the Group A compared to the Group I at 5 minutes (24.70±2.29 cmH2O vs. 23.65±3.14 cmH2O) and 10 minutes (26.48±2.53 cmH2O vs. 25.23±2.66 cmH2O). Group A also took significantly longer to achieve an effective airway. The initial success rate, insertion features, and gastric tube insertion showed no significant differences between the groups. Fiberoptic bronchoscope view scores differed significantly, favouring Ambu AuraGain™. Ventilatory parameters, hemodynamic variables, and postoperative pharyngolaryngeal morbidity did not show any significant differences between the two groups.
Conclusion: Ambu AuraGain™ could be a preferable option for controlled ventilation in the paediatric patients undergoing elective surgery under general anaesthesia compared to i-gel™. However, additional research is required to confirm these findings and investigate other clinical factors.
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Luce V, Harkouk H, Brasher C, Michelet D, Hilly J, Maesani M et al. Supraglottic airway devices versus tracheal intubation in children: a quantitative meta-analysis of respiratory complications. Paediatr Anaesth 2014;24:1088-98
Drake-Brockman TF, Ramgolam A, Zhang G, Hall GL, Ungern-Sternberg BS. The effect of endotracheal tubes versus laryngeal mask airways on perioperative respiratory adverse events in infants: a randomised controlled trial. Lancet 2017;389:701-08
Clery G, Brimacombe J, Stone T, Keller C, Curtis S. Routine cleaning and autoclaving does not remove protein deposits from reusable laryngeal mask devices. Anesth Analg 2003;97:1189-91
i-gel™ combined user guide [Internet]. Intersurgical Ltd. Available from: http://www.intersurgical.com/products/airway-management/i-gel™-supraglottic-airway#downloads/9989. [Last accessed on 22 September, 2021]
Ambu AuraGain™ Disposable Laryngeal Mask Disposable Laryngeal mask [Internet]. Ambu 2018. Available from: https://www.ambu.com/airway-management-and-anaesthesia/laryngeal-masks/product/ambu-aura-i-disposable-laryngeal-mask. [Last accessed on 22 September 2021]
Joshi R, Rudingwa P, Kundra P, Panneerselvam S, Mishra SK. Comparision of Ambu AuraGain™ Disposable Laryngeal Mask and LMA ProSeal in children under controlled ventilation. Indian J Anaesth 2018;62:455-60
Lopez-Gil M, Brimacombe J, Keller C. A comparison of four methods for assessing oropharyngeal leak pressure with the laryngeal mask airway (LMA) in paediatric patients. Paediatr Anaesth. 2001 May;11(3):319-21. doi: 10.1046/j.1460-9592.2001.00649.x. PMID: 11359590
Lee JH, Nam S, Jang YE, Kim EH, Kim HS, Kim JT. Clinical performance of Ambu AuraGain™ Disposable Laryngeal Mask versus i-gel™ in anesthetized children: a prospective randomised controlled trial. Anesth Pain Med 2020;15:173-80
Brimacombe J, Berry A. A proposed fiber-optic scoring system to standardize the assessment of laryngeal mask airway position. Anesth Analg 1993;76:457
Theiler LG, Brueggeney M K, Luepold B, Stucki F, Seiler S, Urwyler N, et al. Performance of the pediatric- sized i-gel™ compared with the Ambu AuraOnce laryngeal mask in anesthetized and ventilated children. Anesthesiology 2011;115:102-10.
Keller C, Brimacombe J, Keller K, Morris R. A comparison of four methods for assessing airway sealing pressure with the laryngeal mask airway in adult patients. Br J Anaesth 1999;82:286-7
Gaur, Yashshwani; Jaju, Rishabh1; Paliwal, Naveen; Choudhary, Usha; Bihani, Pooja; Janweja, Sarita. Comparison of clinical performance of Ambu® AuraGain™ and BlockBuster® in anaesthetised preschool children-A randomised controlled trial. Indian Journal of Anaesthesia 67(5):p 420-425, May 2023. | DOI: 10.4103/ija.ija_286_22
Modiri AR, Frithiof R, Luther T, Frykholm P. The Aura-Gain laryngeal mask for airway management in neonatal inguinal hernia surgery. A feasibility study. Ups J Med Sci. 2023 Feb 27;128. doi: 10.48101/ujms.v128.9234. PMID: 37051289; PMCID: PMC10084493.
Mihara T, Nakayama R, Ka K, Goto T. Comparison of the clinical performance of i-gel™ and Ambu AuraGain™ Disposable Laryngeal Mask in children. A randomised noninferiority clinical trial. Eur J Anaesthesiol 2019;36:411-7.),
Kim HJ, Park HS, Kim SY, Ro YJ, Yang HS, Koh WU. A randomised controlled trial comparing Ambu AuraGain™ Disposable Laryngeal Mask and i-gel™ in young paediatric patients. J Clin Med 2019;8:1235-45.
Hughes C, Place K, Berg S, Mason D. A clinical evaluation of the i-gel™ supraglottic airway device in children. Paediatr Anaesth 2012;22:765-71.
Raj D, Bathla S, Krishna B, Wason R, Girdhar KK. Comparing Ambu AuraGain™ Disposable Laryngeal Mask with i-gel™ as a conduit for fibreoptic guided tracheal intubation for elective surgery under general anaesthesia in adult patients. Trends in Anaesthesia and Critical Care. 2024;101344:101344. doi:10.1016/j.tacc.2024.101344
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Direitos de Autor (c) 2024 Varsha Jakhar, Nidhi Aggarwal, Bhavya Krishna
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