Comparative Evaluation of Intubating Laryngeal Mask Airway and Laryngeal Mask Airway Protector for Endotracheal Intubation in Adult Surgical Patients: A Randomised, Double-Blind Clinical Trial

Abstract Background: Supraglottic airway devices (SADs) are increasingly utilised in both elective and emergency airway management. The intubating laryngeal mask airway (ILMA) and laryngeal mask airway Protector™ (LMAP) represent two widely used SADs with differing designs. This study aimed to compare the efficacy of ILMA and LMAP for endotracheal intubation in adults undergoing elective surgery under general anaesthesia. Materials and Methods: In this prospective, randomised, double-blind trial, 100 adult patients (ASA I–II) were allocated to either the ILMA group (Group I) or LMAP group (Group P). The primary outcome was endotracheal tube (ETT) insertion time. Secondary outcomes included ease of SAD and ETT insertion, number of attempts, adequacy of airway seal, oropharyngeal leak pressure (OLP), and incidence of postoperative sore throat (POST). Results: Mean ETT insertion time was significantly shorter in Group I than in Group P (18.46 ± 3.81 s vs. 20.85 ± 2.98 s; P = 0.001). Ease of SAD insertion was better in Group I (88% vs. 58% “easy”; P = 0.001), as was the ease of intubation (94% vs. 48%; P = 0.001). Group P demonstrated a significantly higher mean OLP (33.72 ± 3.42 cm H 2 O vs. 28.81 ± 2.59 cm H 2 O; P = 0.001). No significant difference was observed in POST incidence (22% vs. 38%; P = 0.081) or number of intubation attempts ( P = 0.538). Conclusion: ILMA facilitates faster and easier endotracheal intubation, while LMAP provides a superior airway seal. Device selection should be guided by clinical context and airway management priorities.