Evaluation of performance of Ambu® AuraGainTM and Laryngeal Mask Airway® SupremeTM in adult patients for elective surgeries under general anaesthesia: A randomized prospective comparative study

Abstract

Second generation supraglottic airway devices (SAD) are gaining importance due to their better seal pressure. Recently introduced Ambu® AuraGain™ (AAG) and LMA® Supreme™ (LMAS) needs evaluation regarding their safety and efficacy. Evaluation of AAG and LMAS in terms of Oropharyngeal Leak Pressure (OLP) and performance characteristics. : A randomised prospective comparative study done in JSS Medical College and Hospital, Mysuru, Karnataka, India. 140 adult patients posted for elective surgeries requiring general anaesthesia were randomised into two groups. SAD was inserted using standardized techniques and evaluated for OLP as primary objective.The data analysed using SPSS software version 22 and descriptive statistics were expressed as mean ± standard deviation (SD), percentage. Kruskal-Wallis rank sum tests were used for quantative data analysis, p <0.05 was considered significant. 138 patients (AAG = 68; LMAS =70) completed the study. There was significant difference noted between the OLP of AAG 33.59±3.65 cmH2O and LMAS 29.67±3.28 cmH2O (p value 0.001). LMAS had first attempt insertion success rate of 87% (61/70) as against 80% (56/70) in AAG, but was statistically insignificant (p value 0.549). Mean time for insertion of LMAS was 18.94± 5.2 seconds and AAG 20.11±4.9 seconds, (p value = 0.18). The ease of insertion of SAD, gastric tube insertion through the SAD and post-operative complications were comparable between the groups. Ambu® AuraGain™ was found to have a higher OLP in sustaining positive pressure ventilation, airway protection against aspiration in patients undergoing general anaesthesia.Oropharyngeal leak pressure is better with Ambu® AuraGain™ compared to LMA® Supreme™ while other performance characteristics of both the devices are comparable.