Comparison of fibreoptic-guided tracheal intubation through LMA Protector and i-gel in adult paralysed patients - A randomised comparative study.

Background and aims: Second-generation supraglottic airway devices (SADs) are used for ventilation and a conduit for fibreoptic-guided tracheal intubation (FGI). LMA Protector is a novel second-generation SAD with a wide airway lumen to pass an adequately sized tracheal tube. Few authors have compared LMA Protector with i-gel for FGI using reinforced tubes, and their results have been contradictory. Polyvinyl chloride (PVC) endotracheal tube (ETT) is the most commonly used ETT in the operation theatre and critical care units. Hence, we conducted this study to compare FGI through i-gel and LMA Protector using PVC ETT.

Methods: After institutional committee approval and trial registration, 66 patients aged 18-70 years with American Society of Anesthesiologists physical status I/II were recruited for this randomised study. Patients were randomly allocated to groups LP and IG. The primary outcome was to compare time to tracheal intubation via two SADs. Insertion characteristics such as the number of insertion attempts, mean time of insertion, oropharyngeal leak pressure, and intubation characteristics (time to view carina, number of attempts, etc.) were considered secondary outcomes. Independent Student's t-test and Mann-Whitney U test were applied for normally distributed and non-normally distributed quantitative variables, respectively.

Results: Demographic parameters were comparable in the two groups (P > 0.05). The time to view the carina, tracheal intubation time, other insertion characteristics, and adverse effects were comparable between the groups (P > 0.05).

Conclusion: LMA Protector and i-gel are technically comparable conduits for fibreoptic-guided tracheal intubation in adult paralysed patients.