CLINICAL PERFORMANCE COMPARISON OF THE I-GEL AND LARYNGEAL MASK AIRWAY SUPREME IN GERIATRIC PATIENTS: A PROSPECTIVE STUDY

Introduction: This study compares the clinical performance and pharyngolaryngeal complications of two second-generation supraglottic airway devices, the I-gel and the laryngeal mask airway supreme, in geriatric patients undergoing elective surgery under general anesthesia. Materials and methods: Following approval from the hospital ethics committee and written informed consent, patients aged 65 years and older, classified with an American Society of Anesthesiologists score of I-III, and scheduled for elective urological surgery under general anesthesia were prospectively included. Participants were randomly allocated into two equalsized groups: I-gel and laryngeal mask airway-supreme. We compared the successful insertion on a first attempt and ease of insertion as a primary outcome, and the secondary outcomes were insertion time, ease of gastric tube insertion, oropharyngeal leak pressure, and intraoperative and postoperative complications. Results: A total of 120 patients were recruited, with 60 in each group. Insertion time for the supraglottic airway device was significantly shorter in the I-gel group (p<0.001). A greater proportion of patients in the I-gel group demonstrated optimal oropharyngeal leak pressure across all measurement points (p<0.001). However, gastric tube placement was facilitated more easily in the laryngeal mask airway supreme group (p=0.018). Furthermore, intraoperative complications were significantly higher in the laryngeal mask airway-supreme group (p=0.008). No notable differences were detected between the groups regarding ease of insertion, success rate on the first attempt, or postoperative complication rates. Conclusion: The I-gel may be preferred for geriatric patients due to its shorter insertion time, lower oropharyngeal leak pressure, and reduced incidence of intraoperative complications. Keywords: Physical Functional Performance; Geriatric Anesthesia; Laryngeal Masks.