The Efficacy Of Non Inflatable Cuff (I-gel and SLIPA) Versus Inflatable Cuff(Soft Seal LMA) Supraglottic Airways In Paralyzed Adult Patients

Aim: To compare the efficacy of non-inflatable cuff supraglottic airways (I-gel and SLIPA) to inflatable cuff soft seal Laryngeal mask airway (SSLMA) in patients requiring general anesthesia and controlled ventilation during elective surgical procedures. Patients and methods: An experimental study design was used, with comparison of three groups of patients using i-gel, SLIPA and SSLMA. Patients with risk of gastro esophageal reflux were excluded. Ease of insertion, quality of seal, effective ventilation, hemodynamic responses, side effects and surgical time were assessed. An Oropharyngeal sealing pressure or ‘leak’ test was performed with the airway devices to quantify the efficacy of the seal with the patient airway. Airway sealing pressure tests claimed to be excellent for clinical purposes. Results: Overall success of insertion was 100% in i-gel, 97.5% and 95% in SSLMA and SLIPA respectively. The i-gel permitted ventilation with a significantly high tidal volume (485 ± 82 ml) at a significantly low peak airway pressure (12 ± 3 cmH2O) and a significantly high leak pressure (26 ± 6.3 cmH2O). All groups show stable hemodynamic responses to insertion and removal of the devices. Insertion time was significantly shorter with i-gel (15 ± 2.5 sec.) compared to SLIPA and SSLMA, 22 ± 4.6 sec. and 19 ± 3.85 sec, respectively. Sore throat was significantly high in SSLMA 30%. Whereas, blood traces on the device and gastric air insufflations were highly significant with SLIPA 8% and 10% respectively. Conclusion: The three disposable SGAs proved to be suitable for controlled ventilation during elective short surgical operations. The i-gel provides effective ventilation with minimal side effects. Whereas, SLIPA is associated with a high incidence of gastric air insufflations, The Soft Seal LMA provides high leakage volume and incidence of sore throat postoperatively.