Comparison of the supraglottic airway device BlockBusterTM and laryngeal mask airway Supreme in anaesthetised, paralyzed adult patients: a multicenter randomized controlled trial

Background: This multicenter prospective, randomized controlled clinical trial compared the clinical performance of supraglottic airway device (SAD) BlockBuster (TM) and laryngeal mask airway (LMA) Supreme for airway maintenance in anesthetized, paralyzed adult patients. Methods: A total of 651 adult patients scheduled for elective surgery in 13 hospitals were randomly allocated into BlockBuster group (n = 351) or Supreme group (n = 300). The primary outcome was oropharyngeal leak pressure (OLP). Duration and ease of insertion, fiberscopic view of positioning, airway manipulations, and complications were also assessed. Results: The OLP was significantly higher in BlockBuster group compared with Supreme group (29.9 +/- 4.2 cmH(2)O vs 27.4 +/- 4.3 cmH(2)O, p < 0.001). Success rate of insertion at the first attempt (90.2% vs 85.1%, p = 0.027), rate of optimal fiberscopic view (p = 0.002) and satisfactory positioning of SAD (p < 0.001) were significantly increased in BlockBuster group. Conclusions: Both SAD BlockBuster (TM) and LMA Supreme are safe, effective, and easy-to-use devices for airway maintenance in anesthetized, paralyzed adult patients, but the SAD BlockBuster (TM) is superior to LMA Supreme in terms of OLP, success rate at the first attempt, and fiber-optic view of positioning.