Comparison of Air-Q ILA and I-gel supragottic airway device for airway management during general anaesthesia- A randomized controlled trial

Introduction: Air-Q ILA and i-gel are frequently used as a primary airway and also as a conduit for subsequent tracheal intubation. Intubation through these Supraglottic airway devices (SAD) has garnered a special enthusiasm since they are privileged with a lesser cost, shorter learning curve and provision for ventilating the patient in between failed attempts of intubation. Since previous studies have not compared the tracheal intubation success rate with these two supraglottic airway devices (SAD), we performed a prospective randomized controlled trial to compare the success rate of endotracheal intubation through air-Q ILA and i-gel. Materials and Methods: After obtaining approval from the institutional research and ethics committee, seventy patients with ASA physical status I and II aged between 18 to 60 years, with normal airways (MP Grade I and II), scheduled for elective surgery were included in the study They were randomized into two study groups (air-Q group or i-gel group). After the insertion of SAD, fiberoptic bronchoscope was passed through it to assess the Brimacombe score. Intubation was attempted through the SAD by blind technique using conventional polyvinyl chloride (PVC) endotracheal tube of appropriate size after removing the fibreoptic bronchoscope. First attempt tracheal intubation success rate, overall tracheal intubation success rate and intubation times were evaluated between the two groups. Results: Insertion of SD and subsequent ventilation was successful in all 70 patients in both groups. First-attempt blind intubation success rate through air-Q was significantly higher than i-gel (air-Q- 25, I-gel-14). Conclusion: Success rate of blind intubation was higher in air-Q when compared to I-gel, albeit the good fibreoptic view of glottis provided by both the devices. We suggest that both devices can be used for blind intubation in the first attempt. If this first attempt fails, it is prudent to use fibreoptic bronchoscope for subsequent att