A prospective, randomized trial of the Ambu AuraGain™ laryngeal mask versus the LMA® protector airway in paralyzed, anesthetized adult men.

Background: We hypothesize that oropharyngeal leak pressures differ between the LMA® Protector™ and the AuraGain™, two novel supraglottic airway devices offering the possibility of intubation.

Methods: Ninety-eight male patients ASAI-II were randomly assigned to the AuraGainTM or ProtectorTM group. Oropharyngeal leak pressure was measured by incrementing cuff volume in 10 mL steps from 10 mL to 40 mL. The primary outcome was oropharyngeal leak pressure at 40 mL cuff volume. Secondary parameters such as transdevice intubation success, intubation time, the number of intubation attempts, and resistance during advancement of the endotracheal tube were determined.

Results: Mean (SD) oropharyngeal leak pressures at cuff volume of 40 mL was 30.1 (6) cmH2O for the AuraGainTM and 28.2 (7) cmH2O for the LMA ProtectorTM (P=0.142). The mean intracuff pressure for the AuraGainTM was 154 (41) cmH2O and 200 (43) cmH2O for the LMA Protector (P≤0.001). The number of attempts to insert the laryngeal mask was higher for the AuraGainTM group (P=0.002). Intubation time was lower in the AuraGainTM group (15.7 s vs. 18.5 s [ProtectorTM group]; P=0.004), and less resistance in advancing the tracheal tube through the AuraGainTM compared to LMA ProtectorTM device (P<0.001). There were no differences in fiberoptic placement of the endotracheal tube, the number of intubation attempts or postoperative morbidity between the groups.

Conclusions: Because of the higher success rate in first time insertion of the laryngeal mask and the gastric tube, respectively, as well as the lower resistance to insertion of the endotracheal tube we conclude a possible easier handling of the AuraGainTM in anesthetized male patients.