Clinical Performance of I-gel versus Ambu AuraGain in Paediatric Patients undergoing General Anaesthesia: A Randomised Clinical Study

Abstract

Introduction: Newer second-generation Supraglottic Airway Devices (SADs) are easy to insert and provide a smooth induction of anaesthesia with minimal haemodynamic pressor response. The paediatric I-gel and Ambu AuraGain are newer SADs that are increasingly being used as alternatives to endotracheal intubation in the paediatric population. Aim: To compare the clinical performance of I-gel and Ambu AuraGain in children undergoing general anaesthesia with respect to ease of insertion, haemodynamic changes, and the frequency and severity of postoperative sore throat. Materials and Methods: This randomised clinical study included 100 children aged 2 to 10 years, belonging to American Society of Anaesthesiologists (ASA) Grade I and II, scheduled for elective surgery under general anaesthesia. They were randomly allocated to Group I (I-gel) and Group A (Ambu AuraGain), comprising 50 patients each. The time taken for SAD placement, the number of attempts, ease of insertion, and the requirement of additional airway manipulations during insertion were observed. Haemodynamic Parameters Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP), SpO2 , and End-tidal Carbon Dioxide [ (EtCO2 ) ]) during the procedure were observed. The frequency and severity of postoperative sore throat were assessed between both groups. Descriptive statistics were applied to all data and reported in terms of mean, Standard Deviation (SD), and percentages, and appropriate statistical tests of comparison were applied. Results: In this study, the demographic data of patients, such as age, weight, gender, and ASA status, were comparable in both groups. There was no statistically significant difference in the time taken for successful SAD placement and the number of attempts required to do the same. Ambu AuraGain was easier to insert than I-gel (p-value<0.05). I-gel required a significantly higher number of additional airway manipulations during insertion compared to Ambu AuraGain (20% in Group I versus 4% in Group A). Haemodynamic parameters were comparable between both groups at all time intervals. The frequency and severity of postoperative sore throat were statistically non significant between I-gel and Ambu AuraGain. Conclusion: Both the I-gel and Ambu AuraGain are reliable and safe devices for maintaining an adequate airway in paediatric patients. However, Ambu AuraGain was easier to insert and required fewer airway manipulations than I-gel during insertion, making it a favourable choice.

Keywords

• airway
• laryngoscopy
• supraglottic airway device