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Comparative study between I-Gel, ProSeal, and classical laryngeal mask airways in pediatrics: a randomized controlled trial

Background and objective Because the I-Gel was industrialized as a noninflatable anatomical seal of the pharynx, larynx, and paralaryngeal configuration, there could be several differences in its insertion, performance, and fiberoptic view compared with the classic laryngeal mask airway (CLMA) and the ProSeal laryngeal mask airway (PLMA). We compared the performance, including easiness of insertion, fiberoptic findings, and differences in the leak pressure among small sizes (1.5–3) with that of the CLMA and the PLMA. We anticipated the better performance of the I-Gel compared with LMA and PLMA. Patients and methods In our study, 60 patients of both sexes, aged 5–15 years, of American Society of Anesthesiologists grades I and II, scheduled for elective surgery were randomly allocated into one of three study groups: group I (20 patients): PLMA group; group II (20 patients): CLMA group; and group III (20 patients): I-Gel laryngeal mask airway group. All patients were premedicated. Anesthetic induction was performed with inhalation of sevoflurane 4–6% or intravenous fentanyl 1 μg/kg intravenously and propofol (2.5–3 mg/kg) in children older than 5 years. After suitable depth of anesthesia, the selected device was inserted. After securing the device, a fiberoptic device was inserted through the airway device to assess the view. The airway device was removed when the patient was awakened. Results The success rate was 100% in the three groups. There were statistically significant differences among the three groups regarding easiness of insertion, time of insertion, and insertion attempts. There were no differences in oropharyngeal leak pressure. The complications were less in I-Gel group compared with the other two groups. Conclusion The study showed that I-Gel was easier to insert and took less time to insert than the PLMA and CLMA. The study showed that the fiberoptic view was better with the I-Gel than the PLMA and CLMA.