TY - JOUR

T1 - AuraGain™ versus i-gel™ for bronchoscopic intubation under continuous oxygenation

T2 - A randomised controlled trial

AU - Svendsen, Christine N.

AU - Rosenstock, Charlotte V.

AU - Glargaard, Gine L.

AU - Strøm, Camilla

AU - Lange, Kai H.W.

AU - Lundstrøm, Lars H.

N1 - Publisher Copyright: © 2022 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

PY - 2022

Y1 - 2022

N2 - 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™.

AB - 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™.

U2 - 10.1111/aas.14042

DO - 10.1111/aas.14042

M3 - Journal article

C2 - 35138634

AN - SCOPUS:85124564186

VL - 66

SP - 589

EP - 597

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 5

ER -