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Self-pressurized air-Q((R)) intubating laryngeal airway versus the LMA((R)) Classic: a randomized clinical trial

 Sang Hee Ha  ;  Min-Soo Kim  ;  Jiwoo Suh  ;  Jong Seok Lee 
 Canadian Journal of Anesthesia, Vol.65(5) : 543-550, 2018 
Journal Title
 Canadian Journal of Anesthesia 
Issue Date
PURPOSE: The self-pressurized air-Q(R) (air-Q SP) intubating laryngeal airway is a relatively new supraglottic airway (SGA) device. The intracuff pressure of air-Q dynamically equilibrates with the airway pressure and adjusts to the patient's pharyngeal and periglottic anatomy, potentially providing improved airway fit and seal. The aim of this prospective randomized study was to compare the clinical performance of air-Q to the LMA(R) Classic SGA. METHODS: Adult patients requiring general anesthesia for elective surgery were prospectively enrolled and randomly assigned to either air-Q SP or the LMA Classic SGA. Oropharyngeal leak pressure (primary endpoint), success rate, insertion features (insertion time, ease of insertion, requirement for device manipulation), sealing function, gastric insufflation, bronchoscopic view, and oropharyngeal complications at device insertion and following its removal (sore throat, dysphagia, dysphonia) were compared. RESULTS: The mean (standard deviation [SD]) oropharyngeal leak pressure just after insertion was similar in the air-Q SP and LMA [16.8 (4.9) vs 18.6 (5.5) cm H2O, respectively; mean difference, 1.8 cm H2O; 95% CI, -0.5 to 4.2; P = 0.13] and did not differ at ten minutes following device insertion. Median [interquartile range (IQR)] peak inspiratory pressure just after insertion was lower in the air-Q SP (11.0 [10.0-13.0] vs 13.0 [11.0-14.0] cmH2O, median difference, 1.0 cm H2O; 95% CI, 0.0 to 2.0; P = 0.03) but no difference was observed at ten minutes. The median [IQR] insertion time was faster with the air-Q SP (15.9 [13.6-20.3] sec vs 24 [21.2-27.1] sec; median difference, 8.1 sec; 95% CI, 5.6 to 9.9; P < 0.001) and improved bronchoscopic viewing grade were seen with the air-Q SP immediately after insertion (P < 0.001). No differences between the groups were observed with respect to the rate of successful insertion at first attempt, overall insertion success rate, ease of insertion, and complications. CONCLUSIONS: The air-Q SP had similar leak pressures but a faster insertion time and superior bronchoscopic viewing grade when compared with the LMA Classic. The air-Q SP is a suitable alternative to the LMA Classic in adult patients and may be a superior conduit for tracheal intubation. TRIAL REGISTRATION: www.clinicaltrials.gov (NCT02206438). Registered 1 August 2014.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Soo(김민수) ORCID logo https://orcid.org/0000-0001-8760-4568
Seo, Jiwoo(서지우) ORCID logo https://orcid.org/0000-0002-6143-9805
Lee, Jong Seok(이종석) ORCID logo https://orcid.org/0000-0002-7945-2530
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