Comparison of Baska® mask versus laryngeal mask airway in elective orthopedic surgery

Background: Supraglottic airway devices (SGAs) are commonly used in both routine anesthesia and emergency airway management. Among these, the classic laryngeal mask airway (cLMA) and the newer Baska® mask have gained prominence. This study aims to compare their clinical performance during elective orthopedic surgeries. Objective: To evaluate and compare the ease of insertion, insertion time, number of attempts, hemodynamic responses, and postoperative complications between the Baska® mask and cLMA in adult patients undergoing elective orthopedic surgery. Methods: A prospective randomized controlled trial was conducted at Medical City Educational Hospital in Baghdad, Iraq. One hundred adult patients (ASA I-II) scheduled for elective orthopedic procedures were randomly assigned into two groups: Baska® mask (n = 50) and cLMA (n = 50). Parameters assessed included insertion time, first-attempt success rate, hemodynamic changes, ventilation efficacy, and postoperative complications such as sore throat, cough, and blood staining. Results: There were no significant differences in demographic characteristics or surgery duration between the two groups. Hemodynamic parameters remained similar, except for a significant difference in heart rate at 25 minutes (P = 0.04). The Baska® mask required slightly more time and attempts for insertion compared to the cLMA, with the number of attempts reaching statistical significance (P = 0.04). However, postoperative complications such as sore throat, cough, and blood-stained secretions were significantly lower in the Baska® group (P = 0.03, 0.04, and 0.05 respectively). Conclusion: Although the Baska® mask may require more insertion attempts, it is associated with fewer postoperative airway complications and a more stable hemodynamic profile compared to the cLMA.