Comparison of clinical performance of i-gel® and Ambu® AuraGain™ in pediatric patients: A randomized controlled study

Background: I-gel® is a prototype among the second-generation supraglottic airway devices (SADs). The Ambu® AuraGain™ is a fairly new, single use, second-generation SAD with a preformed shape. Aim: To compare the oropharyngeal sealing pressure (OSP) of i-gel® and AuraGain™ in young children weighing between 5 and 20 kg. Materials and Methods: This study was conducted as a single-blinded randomized control trial at a tertiary care center over the period of 18 months. Forty children, aged between 6 months and 6 years, weighing 5–20 kg, belonging to the American Society of Anesthesiologists (ASA) Physical Status I, II, and III, undergoing elective surgical procedures, were randomized into two groups: the i-gel® group and Ambu® AuraGain™ group. The primary goal was measuring OSP at 1 min postinsertion and its change at 10 min. The secondary objectives were insertion time, success rate at first attempt, the degree of ease of gastric tube insertion, and perioperative adverse effects. Results: The mean OSP was significantly higher (P < 0.05) in the i-gel group (i.e., 20.0 ± 3.24 at 1 min and 23.45 ± 3.66 at 10 min) as compared to Ambu® AuraGain™ (16.70 ± 3.10 and 19.95 ± 3.1 at 1 and 10 min, respectively). The insertion time and success and complications rate for device placement were comparable. The resistance when inserting gastric tube was significantly higher in the i-gel® group (70%) as compared to the Ambu® AuraGain™ group (20%) in our study (P < 0.05). Conclusion: Our study suggests that i-gel® is superior in achieving OSP, whereas gastric tube insertion is easy with the use of Ambu® AuraGain™.