About this trial
This will be a randomized comparative study comparing the two supraglottic devices i-gel and Protector, intraoperatively, during minor urological procedures under general anesthesia in adult patient.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
ASA I-II
Patients older than 18 years
Procedures in supine and lithotomy position
Disqualifiers
Tumors or anatomical anomalies of the upper airway
Known history of difficult intubation
Limited mouth opening less than 2cm
Decreased compliance of the lungs or the thoracic cage
Trial design
Parallel
Treatments tested in this trial
LMA igel
Deviceadults allocated to the LMA igel group, an LMA igel device will be inserted intraoperatively
LMA protector
Deviceadults allocated to the LMA protector group, an LMA protector device will be inserted intraoperatively
Treatment groups
Trial outcomes
Primary outcomes
Evaluation of the airway sealing pressure of the Laryngeal Mask Airway (LMA) in neutral, extended, and extended-rotated head positions
After the closure of the adjustable pressure limiting valve (APL) of the ventilation machine with a continuous fresh gas flow of 3L/min, a stethoscope for auscultation will be placed to the lateral position of the thyroid cartilage. Leak pressure is defined as the maximum airway pressure (Ppeak) during which no audible sound, like leak, is detected with the placement of the stethoscope at the thyroid cartilage. Successful placement of the laryngeal mask, will be confirmed right after insertion by the auscultation of both hemithoraces, the indication of capnography, and the ratio of inhaled to exhaled pulmonary volume
Secondary outcomes
Success rate of each device for patients with a potential difficult airway according to the Simplified Airway Index
The Simplified Airway Risk Index is a multivariate risk score, ranging from 0 to 12 points, thought to estimate the risk of difficult tracheal intubation based on seven parameters. These seven parameters include the mouth opening, where a mouth opening greater than 4 centimeters between the incisors results in 0 points whereas a distance below results in 1 point, the thyromental distance where thyromental distance greater than 6.5 centimeters results in 0 point whereas a distance between 6-6.5 centimeters is given 1 point and finally a distance below 6 centimeters is given 2 points, the mallampati score where Class I and II of the modified mallampati scoring results in 0 points whereas a class III is given 1 point and a class IV 2 points, the movement of the neck where the ability to move the neck more than 90 degrees results in 0 points whereas a movement range of 80-90 degrees results in 1 point and a movement range below 80 degrees results in 2 points, the ability to underbite mean
The time required for successful placement of the device
This process will involve a maximum of three attempts
Number of attempts to successfully place a nasogastric tube through the specially designed channels of the laryngeal mask
The ease of placement will be assessed by counting the number of attempts required to successfully place the nasogastric tube. Success is defined as the ability to place the tube without complications. "Easy" is defined as successful placement on the first attempt, "moderate" as placement on the second attempt, and "difficult" as placement on the third attempt. If placement is not achieved within three attempts, the procedure will be considered unsuccessful. Successful placement will by assessed by the successful suction of gastric fluid
Documentation of adverse events after the exertion
Complications like blood-stain visible on the LMA after exertion and post-operative sore throat
Sponsors and contacts
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Nikolopoulou Maria Zozefin
Lead sponsor
Sismanoglio General Hospital
Sponsor institution