Comparison of the i-gelTM and the LMA ProsealTM in anesthetized patients undergoing laparoscopic cholecystectomy: a prospective, randomized clinical trial

Abstract

Background: LMA ProsealTM (LMA-P) and i-gelTM are two of the most used supraglottic airway devices
(SADs) with an inbuilt drain channel. We compared these devices regarding efficacy, safety, ease of use
and incidence of adverse events.
Methodology: We randomized 140 patients undergoing elective laparoscopic cholecystectomy to have
either i-gel or LMA-P. We evaluated speed of insertion, success rates, ease of insertion of the drain tube,
leak pressure and tidal volume. We also recorded postoperative oropharyngeal discomfort based on sore
throat, dysphagia and dysphonia.
Results: I-gel had a lower leak pressure and achieves a lower tidal volume compared to the LMA-P (28.3
± 3.3 cmH2O versus 30.9 ± 2.6 cmH2O; p = 0.027), as well as a lower tidal volume provided (562.6 ±
41 ml versus 584.8 ± 44 ml; p = 0.025). Insertion times were lower for i-gel compared with LMA-P (10
± 1.7 versus 11.7 ± 2 s; p = 0.004). Insertion success rate on first attempt as well as drain tube insertion
were comparable between groups. I-gel group complained about a slightly higher sore throat scoring at
2 h postoperatively (p = 0.025).
Conclusions: We found that i-gel had a lower leak pressure and achieves a lower tidal volume compared
to the LMA-P in anesthetised patients undergoing laparoscopic cholecystectomy. Although i-gel was
quicker to insert than LMA-P, it reported higher sore throat scoring at 2 h postoperatively.