Comparison of the performance of the self-pressurized air-Q intubating laryngeal airway with the LMA–ProSeal in pediatric patients under general anesthesia: a randomized controlled trial

Abstract

Background Self-pressurized air-Q intubating laryngeal airway (air-Q SP) is a supraglottic airway device with a noninflatable cuff that does not need continuous monitoring of the cuff pressure. As the ProSeal laryngeal mask airway (PLMA) is considered the ‘state-of-the-art’ supraglottic device, we conducted this randomized trial to evaluate the safety and efficacy of air-Q SP compared with that of PLMA in pediatric patients. Patients and methods The study included 70 pediatric patients aged from 4 to 15 years undergoing elective surgery under general anesthesia who were randomized to either the air-Q SP group or the PLMA group. The primary outcome parameter in this study was the oropharyngeal leak pressure, and the secondary outcome parameters were ease of insertion, time of insertion, first attempt insertion success rate, number of gastric insufflations, fiberoptic glottic view, and complications related to the supraglottic airway device use. Results There was no significant difference between air-Q SP and PLMA regarding first insertion success rate, ease of insertion, oropharyngeal leak pressure, number of gastric insufflations, number of manipulations required to adjust the airway, and complications. Time to insert the air-Q SP was significantly shorter than that of PLMA (13.2±4.2 vs. 17.5±4.8 s, P=0.03). The fiberoptic view was significantly better with air-Q SP than with PLMA (P=0.018). Conclusion The performance of air-Q SP is comparable to that of PLMA as a primary airway device during general anesthesia in pediatric patients, with a shorter insertion time and better fiberoptic view for air-Q SP.