Comparison of performance and efficacy of air-Q intubating laryngeal airway and flexible laryngeal mask airway in anesthetized and paralyzed infants and children.

BACKGROUND: Flexible laryngeal mask airway is a commonly used supraglotic airway device (SAD) during ophthalmic surgeries. Air-Q intubating laryngeal airway (ILA) is a newer SAD used as primary airway device and as a conduit for intubation as well. Available literature shows that air-Q performs equal or better than other SADs in children and adults. However, limited data is available using air-Q in infants and small children <10 kg. So, our aim was ‘To compare the performance and efficacy of these two devices in infants and small children’. Our hypothesis is that air-Q due to its improved cuff design will yield better airway seal pressures and improved laryngeal alignment as compared to flexible laryngeal mask airway.

METHODS: ASA I–II infants and children weighing <10 kg, undergoing cataract or glaucoma surgery, were randomly divided into two groups of 25 each. After induction of anesthesia and muscle relaxation, we measured oropharyngeal leak pressure (OLP), fibre-optic (FO) view of glottis, first insertion success rate, time to insert, and any other complications.

RESULTS: There was no difference between the groups in demographic data, first insertion success rate, time to insert, and postoperative complications. Air-Q provided significantly more OLP [21.1 ± 6.4 cmH2O vs 17.4 ± 4.1 cmH2O, P = 0.02] and better FO view of glottis (good view 84% vs 48%, P = 0.0016) as compared to flexible laryngeal mask airway.

CONCLUSION: We conclude that air-Q is superior to flexible laryngeal mask airway in providing higher airway sealing pressures and better FO grade of laryngeal view in infants and children.