Comparative Evaluation of LMA-Supreme and i-gel Supraglottic Airway Devices with Endotracheal Intubation during Surgical Correction of Traumatic Orbital Injuries

The study aimed to compare endotracheal intubation with i-gel and LMA (laryngeal mask airway) supreme supraglottic airway devices in orbital osteosynthesis surgery.

This comparative perspective single-center randomized study was conducted in Yekaterinburg Clinical Hospitals, Russia, in 2021. The number of 134 patients undergoing orbital plasty after fracture were enrolled in the study and were randomized into three groups: 43 in the endotracheal intubation group, 42 in the LMA-Supreme group, and 49 patients were included in the i-gel group. Hemodynamic parameters, respiratory mechanics, respiration, oropharyngeal leak pressure at different stages of surgical intervention, as well as the time of airway device insertion, the number of attempts, and the need for additional maneuvers to insert the airway device were assessed. For statistical processing, the EZR 1.37 on R commander 3.4.1 was used with the Kruskal-Wallis h-criterion and Pearson’s χ²-test.

In the postoperative period, the assessment of complications associated with the insertion of airway devices was implemented. We did not receive clinically significant differences in mechanical ventilation parameters between groups at the study stages (p>0.05). A reliable difference in oropharyngeal leak pressure at the beginning and the end of the surgical intervention was obtained (p<0.05). The number of complications was minimal and did not differ between the groups (p>0.05).

LMA-S and i-gel supraglottic airway devices allow to provide normal lung ventilation and gas exchange and can be an alternative to endotracheal intubation during orbital osteosynthesis surgery.