Efficacy of two anatomically preformed supraglottic devices, the BlockBuster Laryngeal mask airway and the Ambu AuraGain, for ventilation in anesthetised paralyzed pediatric patients: a randomized trial

BACKGROUND The BlockBuster Laryngeal Mask Airway (LMA) provides a higher oropharyngeal seal pressure (OSP) than Ambu Aura Gain (AAG) in children at an intracuff pressure of 60 cmH2O. Lower intracuff pressures prevent laryngopharyngeal morbidity; therefore, we compared their OSP at 40 cmH2O.METHODS Seventy children scheduled to undergo elective surgery under general anesthesia were randomly assigned to the AAG (Group A) or BlockBuster LMA (Group B) groups. After device placement, the cuff was inflated to 40 cmH2O pressure. Ease of insertion, OSP, number of attempts, insertion time, glottic alignment, peak airway pressure (PAP) to OSP difference (OSP-PAP), and leak fraction were recorded.RESULTS Mean OSP was higher in Group B at 5 min (29.7 ± 1.4 vs. 24.9 ± 2.1 cmH2O;p < 0.0001) and 30 min (29.6 ± 1.3 vs. 24.1 ± 2.6; p < 0.0001). OSP-PAP values were significantly higher in Group B at 5 and 30 min (p < 0.0001). Anatomical alignment was significantly better in Group B (88.6% vs. 57.1%; p = 0.006). The mean times to achieve effective ventilation, ease of device insertion, and gastric catheter insertion were comparable (p = 1.00). Leakage percentages were similar at 5 min (p = 0.11) and 30 min (p = 0.06).CONCLUSION The BlockBuster LMA provided higher OSP, lower PAP-OSP, and better glottic alignment than the AAG. It may be preferred in pediatric patients scheduled for elective surgery.Clinical trial number and registry URL CTRI/2024/06/068284 [Registered on: 04/06/2024] Trial Registered Prospectively