• David T Wong, Alister Ooi, Kawal P Singh, Amelie Dallaire, Vina Meliana, Jason Lau, Frances Chung, Mandeep Singh, and Jean Wong.
• Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada. david.wong@uhn.ca.
• Can J Anaesth. 2018 Jul 1; 65 (7): 797-805.

PurposeStudies comparing the recently introduced Ambu® AuraGain™ (Auragain) with the LMA® Supreme™ (Supreme) supraglottic airway (SGA) have reported conflicting results regarding differences in oropharyngeal leak pressure (OLP). This randomized-controlled trial investigated the OLP of the Auragain compared with the Supreme in patients undergoing ambulatory surgery.MethodsAdult patients with a body mass index ≤ 40 kg·m-2 presenting for ambulatory surgery and requiring an SGA were randomized to receive either the Auragain or the Supreme. Anesthesia was induced with lidocaine (1 mg·kg-1), fentanyl (1-2 μg·kg-1), and propofol (2-3 mg·kg-1). The SGA was inserted using a standard technique with the cuff inflated to 60 cmH2O. The groups were compared for the primary outcome of OLP.ResultsOne hundred sixty-five patients (n = 81, Auragain; n = 84, Supreme) completed the study. Demographics were similar between the groups. The mean (standard deviation [SD]) OLP was significantly higher in the Auragain than in the Supreme group [26.4 (2.8) cmH2O vs 21.6 (3.4) cmH2O, respectively; difference in means (MD), 4.8 cmH2O; 95% confidence interval (CI), 3.9 to 5.8; P < 0.001]. The mean (SD) insertion time was longer in the Auragain than in the Supreme group [13 (4) sec vs 11 (3) sec, respectively; MD, 2 sec; 95% CI, 1 to 3 sec; P < 0.001].ConclusionIn patients undergoing ambulatory anesthesia, the OLP was higher but took longer to insert with the Auragain than with the Supreme. A higher OLP may allow for SGAs to be utilized in a wider range of patients and procedures.Trial Registrationwww.clinicaltrials.gov (NCT02816463). Registered 28 June 2016.

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