• Min Hur, Seungeun Choi, Hyung S Row, and Tae K Kim.
• Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, South Korea.
• Minerva Anestesiol. 2020 Jul 1; 86 (7): 727-735.

BackgroundThe use of second generation supraglottic airway devices is recommended for airway rescue in failed tracheal intubation. This study was performed to compare the clinical performance of the i-gel™ with that of the AuraGain™ in patients with simulated cervical immobilization.MethodsWe conducted a prospective, randomized controlled trial in 104 patients undergoing general anesthesia from June to September 2018 at the Seoul National University Hospital. Patients were randomly allocated to receive either the i-gel™ or the AuraGain™ device. A difficult airway was simulated using a cervical collar limiting the mouth opening and neck movement. The primary outcome was the initial oropharyngeal leak pressure.ResultsThe rate of successful insertion at the first attempt was 92.3% for the i-gel™ and 86% for the AuraGain™. There were no significant differences in the initial and 5-min oropharyngeal leak pressures between the i-gel™ and the AuraGain™ (21±4 vs. 22±5 cmH2O, P=0.229; and 22±5 vs. 23±5 cmH2O, P=0.308, respectively). The time to successful device insertion was shorter (20 [16-23] vs. 25 [20-41] s, P<0.001) and device insertion was easier (P<0.001) in the i-gel™ group than in the AuraGain™ group. The blood staining of the device was more frequently observed in the AuraGain™ (3 [5.8%] vs. 12 [23.5%] patients, P=0.003).ConclusionsThe i-gel™ and the AuraGain™ showed comparable oropharyngeal leak pressures and success rates in the first attempt in patients with simulated cervical immobilization. However, the i-gel™ was easier to insert and required less time for insertion than the AuraGain™.

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