Randomized Assessment of Airway Seal Pressure and Insertion Dynamics: I-gel versus Laryngeal Mask Airway Protector in Adult Difficult Airway Simulation in Patients Undergoing Laparoscopic Surgeries.

Background: Supraglottic airway devices (SGAs) have emerged as effective alternatives to endotracheal intubation for airway management, especially in difficult airway scenarios. This study compared the ease of insertion, insertion time, and oropharyngeal leak pressure (OLP) between the i-gel and the laryngeal mask airway (LMA) protector in adult patients with simulated difficult airway undergoing elective laparoscopic procedures.

Methodology: Sixty adult patients (American Society of Anesthesiologists I-II), aged 18-60 years, scheduled for elective laparoscopic surgeries under general anesthesia, were randomized into two groups: Group I (i-gel) and Group P (LMA Protector). SAD was inserted in a simulated airway scenario made more difficult by using a cervical collar to limit mouth opening and neck movement. Insertion time and ease of insertion were recorded. OLP was measured 5 min after device insertion and pneumoperitoneum. Statistical significance was set at P < 0.05.

Results: I-gel showed shorter insertion time (18.16 ± 3.62 vs. 29.65 ± 7.39 s; P < 0.0001) and greater ease of insertion (P < 0.0001). LMA protector had significantly higher OLP than i-gel, both 5 min postinsertion (37.5 ± 2.86 vs. 27.33 ± 4.69 cm H2O; P < 0.0001) and after pneumoperitoneum (34.83 ± 3.34 vs. 22.83 ± 4.49 cm H2O; P < 0.0001).

Conclusion: While the i-gel is associated with quicker and easier insertion, the LMA protector offers superior airway sealing pressures. Both devices are effective, but the choice should be tailored to procedural demands and clinician preference.