OJAnes  Vol.4 No.12 , December 2014
Cross-Over Assessment of the AmbuAuraGain, LMA Supreme New Cuff and Intersurgical I-Gel in Fresh Cadavers
Abstract: Background: The AmbuAuraGain is a new single-use supraglottic airway device with gastric channel designed to facilitate intubation. The aim of the study was to assess the anatomic position and the performance of the AuraGain in fresh cadavers compared to that of the Intersurgical i-gel and LMA Supreme New Cuff. Methods: The 3 devices were inserted in random order in 7 fresh cadavers without difficult airway criteria. The assessed items were: Insertion time, number of attempts and ease of insertion, airway seal pressure, ease of gastric tube insertion, endoscopic view of vocal cords, efficacy of guided tracheal intubation through the AuraGain and i-gel, and anatomic fit by lateral X-ray and neck dissections. Results: All devices were successfully inserted within 3 attempts, except for one case of the LMA Supreme. Adjusting manoeuvres were often required to accomplish correct insertion. A 16 G gastric tube was easily advanced through all AuraGain and LMA Supreme devices. Fiberoptic tracheal intubation was effectively achieved through all AuraGain and i-gel devices in less than 60 s. Lateral X-ray and neck dissections confirmed optimal alignment of all devices with the respiratory and digestive tracts. Conclusions: Insertion of the new AmbuAuraGain required adjusting manoeuvres in some cases, as observed with the other two devices, and achieved similar airway seal pressures. Passage of a large bore gastric tube was as fast as with the LMA Supreme and ease of guided intubation was similar to that of the i-gel.
Cite this paper: Lopez, A. , Sala-Blanch, X. , Valero, R. and Prats, A. (2014) Cross-Over Assessment of the AmbuAuraGain, LMA Supreme New Cuff and Intersurgical I-Gel in Fresh Cadavers. Open Journal of Anesthesiology, 4, 332-339. doi: 10.4236/ojanes.2014.412047.

[1]   Hernandez, M.R., Klock Jr., P.A. and Ovassapian, A. (2012) Evolution of the Extraglottic Airway: A Review of Its History, Applications, and Practical tips for Success. Anesthesia and .Analgesia, 114, 349-368.

[2]   Wong, D.T., Yang, J.J. and Jagannathan, N. (2012) Brief Review: The LMA SupremeTM Supraglottic Airway. Canadian Journal of Anesthesia, 59, 483-493.

[3]   Lopez, A.M., Valero, R., Lopez, S., Zaballos, M. and Garcia, M.L. (2013) LMA Supreme: New Design or a Pig in a Poke? Revista Española de Anestesiología y Reanimación, 60, 597-598.

[4]   Theiler, L., Gutzmann, M., Kleine-Brueggeney, M., Urwyler, N., Kaempfen, B. and Greif, R. (2012) I-GelTM Supraglottic Airway in Clinical Practice: A Prospective Observational Multicentre Study. British Journal of Anaesthesia, 109, 990-995.

[5]   Kleine-Brueggeney, M., Theiler, L., Urwyler, N., Vogt, A. and Greif, R. (2011) Randomized Trial Comparing the I-GelTM and Magill Tracheal Tube with the Single-Use ILMATM and ILMATM Tracheal Tube for Fibreoptic-Guided Intubation in Anaesthetized Patients with a Predicted Difficult Airway. British Journal of Anaesthesia, 107, 251-257.

[6]   Chen, X., Jiao, J., Cong, X., Liu, L. and Wu, X. (2013) A Comparison of the Performance of the I-Gel vs. the LMA-STM during Anesthesia: A Meta-Analysis of Randomized Controlled Trials. PLoS One, 8, e71910.

[7]   Levitan, R.M., Ochroch, E.A., Kush, S., Shofer, F.S. and Hollander, J.E. (1998) Assessment of Airway Visualization: Validation of the Percentage of Glottic Opening (POGO) Scale. Academic Emergency Medicine, 5, 919-923.

[8]   Garcia-Aguado, R., Vinoles, J., Brimacombe, J., Vivo, M., Lopez-Estudillo, R. and Ayala, G. (2006) Suction Catheter Guided Insertion of the ProSeal Laryngeal Mask Airway Is Superior to the Digital Technique. Canadian Journal of Anesthesia, 53, 398-403.

[9]   Brimacombe, J., Keller, C. and Judd, D.V. (2004) Gum Elastic Bougie-Guided Insertion of the ProSeal Laryngeal Mask Airway Is Superior to the Digital and Introducer Tool Techniques. Anesthesiology, 100, 25-29.

[10]   Teoh, W.H., Lee, K.M., Suhitharan, T., Yahaya Z., Teo, M.M. and Sia, A.T. (2010) Comparison of the LMA Supreme vs the I-Gel in Paralysed Patients Undergoing Gynaecological Laparoscopic Surgery with Controlled Ventilation. Anaesthesia, 65, 1173-1179.

[11]   Russo, S.G., Cremer, S., Eich, C., Jipp, M., Cohnen, J., Strack, M., Quintel, M. and Mohr, A. (2012) Magnetic Resonance Imaging Study of the in Vivo Position of the Extraglottic Airway Devices I-GelTM and LMA-Supreme in Anaesthetized Human Volunteers. British Journal of Anaesthesia, 109, 996-1004.

[12]   Halwagi, A.E., Massicotte, N., Lallo, A., Gauthier, A., Bordreault, D., Ruel, M. and Girard, F. (2012) Tracheal Intubation through the I-Gel Supraglottic Airway versus the LMA Fastrach: A Randomized Controlled Trial. Anesthesia & Analgesia, 114, 172-178.

[13]   Keller, C., Brimacombe, J.R., Radler, C., Puhringer, F. and Brimacombe, N.S. (2000) The Intubating Laryngeal Mask Airway: Effect of Handle Elevation on Efficacy of Seal, Fibreoptic Position, Blind Intubation and Airway Protection. Anaesthesia and Intensive Care, 28, 414-419.

[14]   Brimacombe, J. and Keller, C. (1999) The Laryngeal Mask Airway in Fresh Cadavers versus Paralysed Anaesthetized Patients: Ease of Insertion, Airway Sealing Pressure, Intracuff Pressures and Anatomic Position. European Journal of Anaesthesiology, 16, 699-701.