Safe and effective airway management is the foundation of quality anaesthetic practice. Securing and maintaining the airway is top priority of every anesthesiologist. Endotracheal intubation remains gold standard for this purpose, which requires special training and skills like mask holding, oxygenation, laryngoscopy etc. Intubation process is not without airway complication.1, 2 Misplaced tracheal tubes in difficult circumstances outside operating room may cause brain damage or death of patient. Katz et al reported that up to 25% of endotracheal tubes inserted by paramedics in emergency were found to be improperly placed.3
Supraglottic airway devices (SAD’s) have revolutionized airway management since the invention of the LMA Classic™ (LMA North America Inc., California, USA) by Dr Archie Brain in 1988. They fill a niche between the face mask and the
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Predominant glottic view obtained in classic LMA, Ambu Aura40 and in I-gel was 2 (50%), 1 (63%) and 3(40%) respectively.
Graph 2: Showing glottic view seen through fibreoptic bronchoscope.
Oropharyngeal leak pressure
Oropharyngeal leak pressures are commonly performed with the LMA to indicate the degree of airway protection, the feasibility for positive pressure ventilation and the likelihood for successful supraglottic airway placement.14 We found a higher mean OPLP with I-gel 36.23 ± 3.00 and least with LMA classic 30.90 ± 2.15 which was of statistical significance p=0.000 (Table-5, graph-3).
Patient Group Mean Oropharyngeal Leak Pressure (cm H2O)
LMA classic 30.90 ± 2.15
Ambu Aura40 33.77 ± 4.5
I-gel 36.23 ± 3.00
Table 5: Oropharyngeal leak pressure (OPLP) measured.
Graph 3: Showing oropharyngeal leak pressure (OPLP) in study groups.