Videolaryngoscopic evaluation of hypopharyngeal lesions caused by PLMA and I-gel: A randomised controlled clinical trial

• Published in: Trends in anaesthesia & critical care Vol. 39; pp. 38 - 43
• Main Authors: Gumus, Nevin Esra, Tekin, Murat, Arslan, Zehra Ipek, Ozturk, Murat, Toker, Kamil
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01-08-2021
• Subjects: Dysphagia; Hyperemia; Hypopharynx; I-gel; Oropharyngeal leak pressure; ProSeal laryngeal mask airway; Videolaryngoscopy; I-gel; Hypopharynx; Oropharyngeal leak pressure; ProSeal laryngeal mask airway; Videolaryngoscopy; Dysphagia; Hyperemia
• ISSN: 2210-8440
• DOI: 10.1016/j.tacc.2021.03.012

The ProSeal laryngeal mask airway (PLMA) and I-gel, both second-generation supraglottic airway devices have been compared in previous studies but with inconsistent results regarding their safety and efficacy. Their influence on the hypopharyngeal mucosa have not been evaluated before under videolaryngoscopy.
One hundred ASA I-II patients, aged 18–70 years who underwent elective surgery were randomly allocated for airway management with the I-gel or ProSeal laryngeal mask airway. Mucosal oedema, mucosal colour change and nodularity were evaluated with videolaryngoscopy. Insertion times, oropharyngeal leak pressure and complications were assessed.
For the ProSeal laryngeal mask airway, the mean insertion time (28 ± 15 vs. 18 ± 9.91, P < 0.001) and oropharyngeal leak pressure at the time of insertion (27 ± 7 vs. 23 ± 5, P = 0.01) were significantly higher than the I-gel. With the ProSeal laryngeal mask airway, the incidences of dysphagia were higher at 1 and 12 hours postoperatively (30% vs.12%, P = 0.024) and (16% vs. 4%, %, P = 0.046). A significant relationship was found between hypopharyngeal hyperemia and dysphagia (P = 0.001).
The use of the I-gel resulted in fewer complications than the ProSeal laryngeal mask airway and seems to be advantageous over the ProSeal laryngeal mask airway in adults under general anaesthesia.
•Despite its wide use, the safety profile of the Proseal LM and the Igel LM can be improved.•Dysphagia was higher related with hyperemia in the hypopharyngeal mucosa with PLMA than I-gel.•PLMA provides greater OLP than I-gel so PLMA may be preferred in cases requiring higher OLP.•Mucosal changes secondary to the use of these LM can be predictive of postoperative.