AuraGain vs. LMA Supreme in overweight and obese females: A randomized crossover study

Introduction: AuraGain LM (Ambu Ltd., Ballerup, Denmark) is a new 2nd generation supraglottic device with wide drainage channel. Only few studies in pediatric and adult patients have been published so far (1,2). Methods. After previous power analysis to determine file size, ethical approval Commission (VFN 2/15 ZP) and study registration in the Australian and New database The Zealand Clinical Trials Registry (ACTRN12615001089527) was performed. A prospective randomized cross-over study comparing AuraGain LM with LMA Supreme for overweight and obese women (BMI≤35) for elective performance under general anesthesia. General anesthesia was performed by a combination of propofol and sufentanil a maintained by an inhalation anesthetic (sevoflurane). The primary goal was to compare sealing pressures (OSP). The secondary goals were the overall success rate of insertion, first-time success of insertion, time of insertion and coverage of the vocal cords under the fiberscope. Results Instat software (Graphad Software, La Jolla, CA) was used for statistical evaluation. Higher sealing pressures were recorded with AuraGain LM - 33.3 cmH2O (95% CI 31.9-34.7) than with LMA Supreme - 30.7 cmH2O (95% CI 29.1-32.3) (Wilcoxon sum rank test). The overall success rate of insertion was equally very high in both groups, while frequency of the first-attempt insertion was higher for the LMA Supreme (p = 0.013). LMA Supreme was inserted significantly faster (17.6 vs. 20.1 s, p <0.0001). Fiberoptical scores were better in the AuraGain group - p = 0.05. No significant desaturation nor other significant complications did not occur in the group. Discussion According to this cross-over clinical study, the intsertion of LM AuraGain is slower and requires more attempts, but the device shows significantly higher sealing pressures than LMA Supreme, with better fiberoptic access to the trachea. It could favor its use in laparoscopy, obese patients and difficult intubation. Literature 1. Jagannathan N, et al. A randomized comparison of Ambu AuraGain and the LMA Supreme in infants and children. Anaesthesia 2016; 71: 205-12. 2. Lopez AM, et al. Crossover assessment of Ambu AuraGain, LMA Supreme New Cuff and Intersurgical i-gel in fresh cadavers. Open J Anesthesiol 2014; 4: 332-9