A Comparative Study of Supreme LMA Vs I-gel: Two Supraglottic Airway Devices in Short Surgical Procedures


  • Lokmanya Tilak Municipal Medical College & General Hospital, Department of Anaesthesia, Mumbai, Maharashtra, 400022, India


Background and Aims: The objective of this prospective, randomized trial was to compare I-Gel with Supreme LMA in anaesthetized spontaneously breathing patients for short surgical procedures. Material and Methods: Sixty patients of ASAI -ASAII of either gender between 18-60 years undergoing short surgical procedures were randomly assigned to I-gel (Group I) or LMA-Supreme (Group S). After induction with propofol the supraglottic airway device was inserted. We compared the ease and time required for insertion, airway sealing pressure and adverse events related to airway. Results: There were no significant differences in demographic and haemodynamic data. I-gel insertion was easier than LMA Supreme but statistically not significant (p > 0.05) (Chi square test). Numbers of attempts for successful insertions were comparable and in majority device was inserted in first attempt. Although the airway sealing pressure was significantly higher with Group S (25.73+2.21 cm of H2O), the airway sealing pressure of Group I (20.0+2.94 cm of H2O) was very well within normal limit (Student’s t test). There was no evidence of airway trauma, regurgitation and aspiration. Conclusion: I-Gel with acceptable limits airway sealing pressure, easier to insert, less traumatic with lower incidence of sore throat. Hence I-Gel can be a good alternative to LMA-Supreme.


Adverse Events, I-gel, Supreme LMA, Seal Pressure, Time for Insertion

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Uppal V, Gangaiah S, Fletcher G, Kinsella J. Randomized crossover comparison between the i-gel and the LMA-Unique in anaesthetized, paralysed adults. Br J Anaesth. 2009; 103:882–5. https://doi.org/10.1093/bja/aep292 PMid:19846406

Francksen H, Renner J, Hanss R, Scholz J, Doerges V, Bein B. A comparison of the i-gel with the LMA-Unique in nonparalysed anaesthetised adult patients. Anaesthesia. 2009; 64:1118–24. https://doi.org/10.1111/j.1365-2044.2009.06017.x PMid:19735404

Uppal V, Fletcher G, Kinsella J. Comparison of the i-gel with the cuffed tracheal tube during pressure-controlled ventilation. Br J Anaesth. 2009; 102:264–8. https://doi.org/10.1093/bja/aen366 PMid:19151051

heiler LG, Kleine-Brueggeney M, Kaiser D, Urwyler N, Luyet C, Vogt A, et al. Crossover comparison of the laryngeal mask supreme and the i-gel in simulated difficult airway scenario in anesthetized patients. Anesthesiology. 2009; 111:55–62. https://doi.org/10.1097/ALN.0b013e3181a4c6b9 PMid:19512881

Ragazzi R, Finessi L, Farinelli I, Alvisi R, Volta CA. LMA SupremeTM vs i-gelTM- a comparison of insertion success in novices. Anaesthesia. 2012; 67:384–8. https://doi.org/10.1111/j.1365-2044.2011.07002.x PMid:22329593

Teoh WH, Lee KM, Suhitharan T, Yahaya Z, Teo MM, Sia AT. Comparison of the LMA Supreme vs thei-gel in paralysed patients undergoing gynaecological laparoscopic surgery with controlled ventilation. Anaesthesia. 2010; 65:1173–9. https://doi.org/10.1111/j.1365-2044.2010.06534.x PMid:20958278

Helmy A, Atef HM, El–Taher E, Henidak A. Comparative study between I-gel, a new supraglottic airway device, and classical laryngeal mask airway in anesthetized spontaneously ventilated patients. Saudi J Anaesth. 2010; 4:131–6. https://doi.org/10.4103/1658-354X.71250 PMid:21189847 PMCid:PMC2980656

Gasteiger L, Brimacombe J, Perkhofer D, Kaufmann M, Keller C. Comparison of guided insertion of the LMA ProsealTM vs the i-gel TM. Anaesthesia. 2010; 65:913. https://doi.org/10.1111/j.1365-2044.2010.06422.x PMid:20645948

Suhitharan T, Teoh WH. Use of extraglottic airways in patients undergoing ambulatory laparoscopic surgery without the need for tracheal intubation. Saudi J Anaesth. 2013; 7:436–41. https://doi.org/10.4103/1658-354X.121081 PMid:24348297 PMCid:PMC3858696

Chew EE, Hashim NH, Wang CY. Randomised comparison of the Supreme LMA with the I-Gel in spontaneously breathing anaesthetised adult patients. Anaesth Intensive Care. 2010; 38:1018–22. PMid:21226431

Gabbot D, Beriger R. The I-gel supraglottic airway: A potential role for resuscitation. Resuscitation. 2007; 73:161–4. https:// doi.org/10.1016/j.resuscitation.2006.10.026 PMid:17289250

Richez B, Saltel L, Banchereau F, Torrielli R, Cros AM. A new single use supraglottic airway device with a noninflatable cuff and an esophageal vent: An observational study of the i-gel. Anesth Analg. 2008; 106:1137–9. https://doi.org/10.1213/ane.0b013e318164f062 PMid:18349185

Kannaujia A, Srivastava U, Saraswat N, Mishra A, Kumar A, Saxena S. A preliminary study of I-gel: A new supraglottic airway device. Indian J Anaesth. 2009; 53:52–6. PMid:20640078 PMCid:PMC2900034

Cook TM, Gatward JJ, Handel J, Hardy R, Thompson C, Srivastava R, Clarke PA. Evaluation of the supreme LMA in 100 non-paralysed patients. Anaesthesia. 2009; 64:555–62. https:// doi.org/10.1111/j.1365-2044.2008.05824.x PMid:19413827

Hosten T, Gurkan Y, Ozdamar D, Tekin M, Toker K, Solak M. A new supraglottic airway device: LMA-supreme, comparison with LMA-Proseal. Acta Anaesthesiol Scand. 2009; 53:852–7. https://doi.org/10.1111/j.13996576.2009.01986.x PMid:19426239

Yao WY, Li SY, Sng BL, Lim Y, Sia AT. The Supreme LMA™ in 700 parturients undergoing Cesarean delivery: An observational study. Can J Anaesth. 2012; 59:648–54. https://doi.org/10.1007/s12630-012-9718-4 PMid:22556005

Russo SG, Cremer S, Galli T, Eich C, Brauer A, Crozier TA, Bauer M, Strack M. Randomized comparison of the I-Gel™, the supreme LMA™, and the laryngeal tube suction-D using clinical and fibreoptic assessments in elective patients. BMC Anesthesiol. 2012; 7:12–8. https://doi.org/10.1186/14712253-12-18

Gatward JJ, Cook TM, Seller C, Handel J, Simpson T, Vanek V et al. Evaluation of the size 4 i-gelTM airway in one hundred non-paralysed patients. Anaesthesia. 2008; 63:1124–30. https://doi.org/10.1111/j.1365-2044.2008.05561.x PMid:18616521

Keijzer C, Buitelaar D, Efthymiou K, Sramek M, Cate J, Ronday M et al. A comparison of postoperative sore throat and neck complaints after the use of the I-gel and the La Premiere disposable laryngeal mask: A double-blinded, randomized, controlled trial. Anesth Analg. 2009; 109:1092–4. https://doi.org/10.1213/ANE.0b013e3181b6496a PMid:19641052

Twing S, Brown JM, Williams R. Swelling and cyanosis of tongue associated with use of laryngeal mask airway. Anaesthesia and Intensive Care. 2000; 28:449–50.

Ouellete RG. The effect of nitrous oxide on laryngeal mask cuff pressure. American Association of Nurse Anesthetist Journal. 2000; 68:411–4.


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