AuraGain™ versus i-gel™ for bronchoscopic intubation under continuous oxygenation: A randomised controlled trial

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Introduction: After failed mask ventilation and tracheal intubation, guidelines issued by the Difficult Airway Society recommend placing a second generation supraglottic airway device to secure oxygenation. Ultimately, a secure airway can be obtained by tracheal intubation through the supraglottic airway device using a bronchoscope. In this randomised trial, we compared the AuraGain™ with the i-gel™ as conduit for bronchoscopic intubation under continuous oxygenation performed by a group of anaesthesiologists with variable experience in a general population of patients. Method: We randomised one hundred patients who were equally allocated to flexible bronchoscopic intubation through the i-gel™ or the AuraGain™. In a random order, 25 anaesthesiologists each performed four intubations, two using the i-gel™ and two using the AuraGain™. Our primary outcome was ‘total time for airway management’; i.e. total time from manually reaching the SAD to successful FBI confirmed at the end of the first inspiratory downstroke on the capnography curve. Results: In total, 87% (95% CI, 79%–92%) of the patients were successfully intubated through the allocated supraglottic airway device. There was no difference in total time for airway management between the i-gel™ and the AuraGain™ (199 vs. 227 s, p =.076). However, there was a difference in time for placement of the i-gel™, compared to the AuraGain™, (37 vs. 54 s, p <.001). There were nine failed intubations in the AuraGain™ group compared to four in the i-gel™ group (p =.147). Conclusion: We found no difference in total time for airway management between using the i-gel™ and using the AuraGain™.

TidsskriftActa Anaesthesiologica Scandinavica
Udgave nummer5
Sider (fra-til)589-597
Antal sider9
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
The authors would like to thank Sandra Viggers for helping with the design of our online teaching resource. Equipment used for this trial was sponsored by the Research Fund, Nordsjaellands Hospital.

Publisher Copyright:
© 2022 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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