Comparative Evaluation of the i-gel and ProSeal Laryngeal Mask Airway on Respiratory Mechanics During Laparoscopic Surgery – A Randomized Controlled Trial

Suhasini Hubli, Preethi Rioniz, Shwetha C. Poojary, Rashmi R, Harshavardhana H. S
Author(s)
1Assistant Professor, Department of Anaesthesiology, K. H. Patil Institute of Medical Sciences, Gadag, Karnataka, India. 2Assistant Professor, Department of Pharmacology, Chikkamagaluru Institute of Medical Sciences, Chikkamagaluru, Karnataka, India. 3Assistant Professor, Department of Otorhinolaryngology, Karwar Institute of Medical Sciences, Karwar, Karnataka, India. 4Assistant Professor, Department of Anesthesiology, Karnataka Institute of Medical Sciences and Research Institute, Hubballi, Karnataka, India. 5Assistant Professor, Department of Anesthesiology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India

Abstract

Background: Supraglottic airway devices (SADs) have emerged as effective alternatives to endotracheal intubation for airway management during laparoscopic surgery. Among second-generation SADs, the i-gel and ProSeal laryngeal mask airway (PLMA) are widely used. However, differences in their respiratory mechanics and clinical performance remain a subject of interest. The aim is to compare the i-gel and PLMA with respect to respiratory mechanics, ease of insertion, airway trauma, and oropharyngeal leak pressure in adult patients undergoing elective laparoscopic surgery. Material and Methods: This prospective randomized controlled study was conducted on 100 adult patients undergoing elective laparoscopic surgery who were randomly allocated to either the i-gel (n=50) or the PLMA (n=50) groups. Dynamic compliance, peak airway pressure, airway resistance, heart rate, and mean arterial pressure were recorded at predefined intraoperative time points. Ease of insertion, blood staining of the device following removal, and oropharyngeal leak pressure were also assessed. Statistical analysis was performed using IBM SPSS Statistics v20. Results: Baseline demographic and clinical characteristics were comparable between the groups. The i-gel demonstrated significantly higher dynamic compliance and lower peak airway pressure at all measured time points (all p < 0.01). Airway resistance was significantly lower with the i-gel at 10 minutes after pneumoperitoneum (p = 0.021). First-attempt insertion success was higher with the i-gel (92% vs. 84%), although the difference was not statistically significant. Blood staining of the device was significantly less frequent with the i-gel (12% vs. 30%; p = 0.027). In contrast, the PLMA achieved a significantly higher oropharyngeal leak pressure, indicating a superior airway seal. Conclusion: The i-gel provided superior respiratory mechanics, lower airway trauma, and comparable ease of insertion compared with the PLMA during laparoscopic surgery. However, the PLMA offered a superior oropharyngeal seal. Both devices are effective for airway management, with the choice depending on the clinical priority between ventilatory performance and airway sealing.

Keywords: Airway devices, i-gel, laryngeal masks, dynamic compliance, airway resistance, peak airway pressure.

Outline