Key result
I-gel and Baska mask maintain adequate airway seal versus ETT despite differing leak fractions.
Why the study?
Supraglottic airway devices are frequently used instead of endotracheal intubation in laparoscopic surgeries, prompting a comparison of the performance of the I-gel and Baska mask with the endotracheal tube in patients undergoing laparoscopic cholecystectomy under general anesthesia.
Does I-gel or Baska mask improve airway sealing and leak fraction compared to endotracheal tube in patients undergoing laparoscopic cholecystectomy?
RCT (n=84)
randomized
Does I-gel or Baska mask improve airway sealing and leak fraction compared to endotracheal tube in patients undergoing laparoscopic cholecystectomy?
p-value: p=0.000
I-gel and Baska mask can safely maintain an adequate airway seal during laparoscopic cholecystectomy, with I-gel offering faster insertion times compared to endotracheal intubation.
I-gel and Baska mask support adequate airway sealing as alternatives to endotracheal intubation in laparoscopic cholecystectomy; extends RCT evidence for supraglottic devices under pneumoperitoneum.
Background: Supraglottic airway devices are frequently used instead of endotracheal intubation in laparoscopic surgeries. Two such devices, I-gel (IG) and Baska mask (BM), have been compared with respect to their sealing properties and leak fraction (LF) in comparison to the endotracheal tube. Aims and Objectives: The aim of the present study is to compare the performance of IG and BM with endotracheal tube in patients undergoing laparoscopic cholecystectomy under general anesthesia. Materials and Methods: In this randomized trial, 84 patients scheduled for laparoscopic cholecystectomy under general anesthesia were randomized to group (endotracheal tube [ETT], n=28), group BM (BM, n=28), or group IG (IG, n=28). All the patients received standard general anesthesia and the airway was maintained with either of three devices. The primary outcomes were the difference in the LF and airway sealing pressure (ASP) at different time points before and after pneumoperitoneum. Secondary outcomes were insertion-time, number of insertion attempts, and gastric insufflations. Heart rate and blood pressure were recorded. Complications such as sore throat, coughing, laryngospasm, blood staining of the device, and aspiration were noted. Results: P-values of LF of the three groups at time points T- after insertion (Ti), T-after pneumoperitoneum (Tp), and T- after peritoneal deflation (Tr) were 0.000 each and P-values of ASP at those time points were 0.000 each, respectively. Insertion time was significantly less for IG than ET (P<0.001). Heart rate and blood pressure showed P-values at Ti and Tp (P=0.004 and 0.000). Conclusion: It was concluded that IG or BM can maintain an airway with adequate seal and were not associated with any incidence of aspiration or laryngospasm. IG placement was found to be easier whereas the ease of ventilation was noted with BM.
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Gain et al. (2024) conducted an RCT in Laparoscopic cholecystectomy (n=84). I-gel and Baska mask vs. Endotracheal tube was evaluated on Difference in the leak fraction (LF) and airway sealing pressure (ASP) at different time points before and after pneumoperitoneum (p=0.000). I-gel and Baska mask maintained an airway with adequate seal during laparoscopic cholecystectomy, with significant differences in leak fraction and airway sealing pressure across groups (P=0.000).
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