Comparative Evaluation of Two Supraglottic Airway Devices: Intubating Laryngeal Mask Airway (ILMA) and Ambu Aura-i for Blind Tracheal Intubation in Adults: A Randomized Clinical Trial

Document Type : Original Article

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Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.

Abstract

Background: Supraglottic airway devices (SGD) are a group of airway devices that can be inserted into the pharynx to allow ventilation, oxygenation, and administration of anesthetic gases. These devices are used for primary airway management, rescue ventilation when facemask ventilation is difficult, and as a conduit for endotracheal intubation.
Aim of the study: Was to compare between intubating laryngeal mask airway (ILMA) and Ambu Aura-i as regards success rate for blind endotracheal intubation in adults undergoing elective surgery under general anesthesia.
Results: 100 patients were randomly divided into two equal groups. Group A (n= 50) were intubated using ILMA, whereas those in group B (n= 50) were blindly intubated using Ambu Aura-i. The data demonstrated that success rate for blind intubation in group A 86.9% while in group B 72.3% (p value= 0.122). Time for endotracheal intubation in seconds was 97±24.279 in the group A while it was 102.94±32.755 in group B (P= 0.374). Time required for placement of SGDs in seconds was 56.80±14.480 in group A while it was 66.38±31.514 (p= 0.064). Number of attempts for SGDs in the first attempt (ILMA= 36/72, 72%; Ambu Aura-i 36/72, 72%), in the second attempts (ILMA= 10/21, 20%; Ambu Aura-i= 11/21, 22%) in the third attempts (ILMA= 4/7, 8%; Ambu Aura-i= 3/7, 6%) (P= 0.870). Group A 46/93, 92% while in group B 47/93, 94%) (p= 1). Change >20% of baseline vital data was recorded e.g. mean arterial blood pressure (MAP) (p= 0.281) while Heart rate (p= 0.926). Complications e.g. blood on endotracheal tube (ETT) (p= 0.554), blood on SGDs (p= 0.836), abdominal pain (p= 1), Hoarseness of voice (p= 0.585) & desaturation, aspiration, laryngospasm & laryngeal edema) weren’t noted.
Conclusion: Ambu Aura-i and ILMA are good tools for maintaining ventilation and oxygenation. There is no difference between ILMA & Ambu Aura-i as regards successful blind intubation so Ambu Aura-i a comparable alternative to ILMA for blind tracheal intubation.

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