A comparative study of two supraglottic airway devices the i-gel® and LMA supreme TM in reducing the incidence of post operative sore throat in patients undergoing day care surgeries under general anesthesia

Postoperative sore throat is a common complaint after general anaesthesia. Airway trauma caused by laryngoscopy and endotracheal intubation are mainly responsible for this. Supraglottic airway devices offer an alternative to traditional tracheal intubation with potential benefit for ease of fit, less disturbance of the airway and less incidence of postoperative sore throat. The aim of the study was a comparative analysis of the effectiveness of i-gel® supraglottic airway device and LMA SupremeTM in reducing the incidence of postoperative sore throat in patient undergoing day care surgery under general anaesthesia.

A prospective observational study was performed in 94 patients who qualified the inclusion criteria, after detailed pre-anesthetic evaluation and obtaining informed consent. They were randomly divided into 2 groups. Standard fasting guidelines were followed. Two senior anesthesiologists (each with more than 10 years’ experience) were the primary attending anesthesiologists. One of them used the i-gel® for all cases and the other used LMA SupremeTM for all cases. IV induction was done with Fentanyl, propofol and muscle relaxant (Atracurium). Airway was secured with either i-gel® or LMA SupremeTM and was confirmed by end tidal CO2 tracing and absence of an audible leak. Anaesthesia was maintained with O2- N2O (1:1) mixture and Sevoflurane. At the end of the surgery, patient was ventilated with 100% oxygen and neuro muscular blockade was reversed with neostigmine and glycopyrrolate. After ensuring he/she was awake and breathing comfortably, gentle oral suctioning was done with lubricated suction catheter (size-14). Oral or pharyngeal trauma in the form of blood streaked suction/ frank blood/ blood clots was noted and documented. Then the supraglottic airway i-gel® or LMA SupremeTM was removed and patient allowed to breath oxygen through Hudson face mask.
An enquiry was made by the primary investigator regarding throat discomfort/ throat pain on swallowing/ dysphonia and documented accordingly at 1 hour, 6 hour and during discharge after the surgery by means of questionnaire. Statistical analysis was performed using Microsoft Excel and SPSS version 18.0 (Trial version). Chi-square test and Fisher’s exact test were used for the comparison of qualitative variables and independent sample t-test for the comparison of quantitative variables. A p-value less than 0.05 was taken as significant.

Statistical analysis showed that incidence of both postoperative sore throat and airway trauma were significantly higher in LMA SupremeTM group compared to i-gel® group. There is no statistically significant difference in odynophagia among the patients who received LMA SupremeTM and i-gel®. VAS Score for pain was slightly higher, but not statistically significant in LMA SupremeTM group compared to i-gel®.

Our study concluded that i-gel® is more efficacious than LMA SupremeTM in reducing airway trauma and postoperative sore throat during day care surgeries under general anaesthesia.


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