A Comparative Study between Protector- and Supreme-type Laryngeal Mask Airways in Patients Undergoing Laparoscopic Surgery under General Anaesthesia

Abstract Background and Aim: Supraglottic airway devices (SADs) have become an important part of the management of patients undergoing general anaesthesia during surgeries. There are various SADs available today, with laryngeal mask airway (LMA) considered the most useful and efficient option. However, various modifications have led to the development of different iterations of LMAs for use among different populations. Therefore, we aimed to compare the LMA Protector ‘Cuff Pilot’ and LMA Supreme in terms of oropharyngeal leak pressure (OLP), insertion success rate, ease of insertion, haemodynamic variables (blood pressure, heart rate and mean arterial pressure) and postoperative complications in patients undergoing general anaesthesia. Materials and Methods: A total of 200 American Society of Anaesthesiologists physical status I and II patients were included and randomised to Group A and Group B. After the induction of anaesthesia with standard protocol, SAD was inserted. The primary outcome was measuring the OLP of both the devices. The secondary outcomes were to evaluate the ease of insertion, insertion success rate, haemodynamic parameters and postoperative complications. Results: Statistical analysis showed that age and gender were comparable between the groups, as were anthropometric parameters (weight, height and body mass index), American Society of Anaesthesiologist grade and Mallampati score. In terms of intraoperative findings, the two groups were comparable in terms of ease of insertion, number of insertion attempts and surgery duration, whereas OLP was significantly higher in those managed by LMA Protector. All haemodynamic parameters (heart rate, systolic and diastolic blood pressure, mean arterial pressure, SpO 2 and EtCO 2 ) were noted. In terms of postoperative complications, incidence of sore throat at 30 min postoperative was significantly higher in those managed by LMA Supreme as compared to those managed by LMA Protector. Nausea and vomiting at 30 min postoperative were higher in the LMA Protector group, but this difference was not significant. Conclusions: Our findings showed that LMA Protector ‘Cuff Pilot’ and LMA Supreme were comparable in efficacy in terms of haemodynamic parameters. However, a higher OLP could be achieved with LMA Protector as compared to LMA Supreme, with similar insertion attempts and ease of insertion.