Anil Kumar Mysore Ramakrishna1, Sarika Manjunath Shetty2, Anup Natha Ramachandragowda3, Vyshnavi Sriram4, Shali Sohail5, Archana Shivashankar6
BACKGROUND
A wide array of supraglottic airway devices (SAD) are available for the present day
anaesthetic practice, each having its own unique features. Laparoscopic surgeries
demand meticulous airway maintenance due to the impact of pneumoperitoneum
on cardiorespiratory physiology. It thus becomes imperative to have knowledge
about the most optimal SAD that can be used for laparoscopic surgeries to provide
good quality anaesthesia. The objective of this randomised trial was to compare
the airway sealing pressure (ASP) of Baska mask and i-gel and overall success rate
in patients undergoing laparoscopic surgeries under general anaesthesia and
controlled ventilation.
METHODS
One hundred and forty patients undergoing laparoscopic surgeries were randomly
assigned to either Baska group (Group B) or i-gel group (Group I). Anaesthesia
was induced with propofol 2 - 2.5 milligram per kilogram (mg / kg) and relaxation
achieved with vecuronium 0.1 mg / kg and SAD was inserted. The primary
outcome was airway sealing pressure (ASP) noted after insertion of the device.
The secondary outcome measures included the number of attempts and time
taken for successful insertion, ASP after gas insufflation of abdomen, Brimacombe
grading, hemodynamic changes, airway morbidity (blood on the SAD upon
removal, post-operative sore throat, dysphagia and dysphonia) and any other
adverse events associated with the use of the devices.
RESULTS
There were no significant differences in demographic and hemodynamic data. ASP
after insertion of the device was significantly higher (p < 0.0001) with Baska than
i-gel (41.45 + 4.72 versus 30.29 + 5.76 cm H2O respectively). Brimacombe
scoring of grade four was seen in 75.3 % of Baska compared to 18 % in i-gel
group. Time taken to insert Baska was significantly more than with i-gel (14.84
versus 11.25 seconds respectively, P < 0.001). However, first time success was
more with Baska than with i-gel (147 versus 140 respectively).
CONCLUSIONS
Both Baska and i-gel can be used safely and effectively in laparoscopic surgeries.
Baska provides a better ASP and Brimacombe view than i-gel. However, i-gel offers
the advantage of easier insertion in shorter time.
KEYWORDS
Supraglottic Airway Device, Baska Mask, i-gel, Airway Sealing Pressure
