A Comparative Study of the Ease of Insertion of Proseal Laryngeal Mask Airway (PLMA) and I-Gel

Abstract

Background: I-gel and Proseal LMAare both modifications of cLMAwith a cuff which improves oval seal around the glottis, and a drainage tube to  provide a channel for regurgitated fluid and gastric tube placement. We compared the ease of insertion of the I-gel versus PLMA, the time of  insertion, and complications following passage of the two airway devices.

Patients and Methods: Following ethical committee approval, patients were randomly allocated into one of two groups; Group I-gel (n=30) had  I-gel insertion and group PLMA(n=30) had PLMAinsertion. Induction of anaesthesia was achieved with propofol 2.5 mg/kg, followed by atracurium  0.5mg/kg, after test ventilation. Introduction of airway device was done 3 minutes after administration of muscle relaxant. The heart rate, blood  pressure were taken at baseline, after induction, 2, 4, 6, 8 and 10 minutes after airway insertion. Ease of insertion and time taken for placement of  device, and ease of passage of gastric tube were assessed and compared.

Results: The ease of insertion of the devices was significantly better in the I-gel group than the PLMAgroup, p = 0.017. The difference in mean heart  rate between both groups at 2, 4 and 6 minutes post insertion was significant, p<0.05. The difference in MAP, for PLMAgroup was significantly  higher than the I-gel group at 2 minutes post insertion of device and for the rest of the study period (p<0.05). More incidence of complications in  PLMA group than I-gel group was observed, p=0.045. However passage of gastric tube in both groups were comparable.

Conclusion: The insertion of I-gel is easier compared to PLMA with better haemodynamic stability. Both airway devices exhibited similar ease of  insertion of gastric tube.