• Abhyuday Kumar, Chandni Sinha, Neeraj Kumar, Ajeet Kumar, Bindey Kumar, Amarjeet Kumar, and Rajnish Kumar.
• Department of Anesthesiology, AIIMS, Patna, India.
• Paediatr Anaesth. 2022 Jul 1; 32 (7): 843-850.

BackgroundPrevious studies have shown Proseal LMA and I gel similar to endotracheal intubation in ventilatory ability in pediatric laparoscopic surgeries.AimsThe primary aim of this study was to assess whether there is a significant difference in the oropharyngeal leak pressure between Ambu Auragrain, I-gel, and Proseal LMA during pediatric laparoscopic surgery.MethodsIn this randomized controlled trial, 90 male patients of American Society of Anesthesiologists physical status I aged between 6 months and 10 years who were scheduled for laparoscopic single-sided inguinal hernia repair were recruited and randomly allocated to three groups in which airway was secured with Ambu Auragain, I gel, or Proseal LMA. The primary outcome was oropharyngeal leak pressure. The secondary outcomes were peak pressures before and after pneumoperitoneum, fiberoptic view, insertion attempts, insertion time, manipulations, perioperative and postoperative anesthesia-related problems. Continuous variables were compared using the one-way analysis of variance or the Kruskal-Wallis test with post hoc Turkey analysis. Categorical and ordinal data were compared using the chi-square test or Fisher's exact test.ResultsOropharyngeal leak pressure before pneumoperitoneum was higher with I gel as compared to Ambu Auragain (27.36 ± 5.72 cm of H2 O vs 23.56 ± 5.72 cm of H2 O) (p = .021) and PLMA (27.36 ± 5.72 cm of H2 O vs 23.24 ± 4.35 cm of H2 O) (p = .011). Oropharyngeal leak pressure after pneumoperitoneum was also higher with I gel as compared to Ambu Auragain (31.58 ± 4.35 cm of H2 O vs 26.83 ± 5.00 cm of H2 O) (p = .001) and Proseal LMA (31.58 ± 4.35 cm of H2 O vs 27.03 ± 3.80 cm of H2 O) (p = .002). Oropharyngeal leak pressures of Ambu Auragain and Proseal LMA were comparable. Postoperative complications were similar in all the supraglottic airway devices. No regurgitation or aspiration-related problem was observed in our study.ConclusionI gel had a higher oropharyngeal leak pressure than the other two supraglottic airway devices and therefore may represent a better choice in situations where higher ventilatory pressures may be necessary, for example, in extremes of weight trendelenburg position, etc. CLINICAL TRIAL IDENTIFIER: Clinical trial registry of India (CTRI/2018/11/016445).© 2022 John Wiley&Sons Ltd.

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