Clinical Performance Comparison of LMA Protector™ Cuff Pilot™ and LMA Supreme™ When Used in Anesthetized, Non-paralyzed Patients

Introduction The advancement of supraglottic airways (SGAs) has eased airway management, especially for anesthetists. There were functional improvements implemented to the newer SGA. We aim to assess the clinical performance of laryngeal mask airway (LMA) Protector™ Cuff Pilot™ (Teleflex Inc., Wayne, Pennsylvania, USA) against LMA Supreme™ (Teleflex Inc., Wayne, Pennsylvania, USA), in terms of oropharyngeal leak pressure (OLP), successful insertion attempts, mean insertion time, ease of gastric tube insertion, laryngeal view, and incidence of sore throat among anesthetized, non-paralyzed patients undergoing general anesthesia. Methods In this prospective single-blinded study, 60 patients were randomized to use either LMA Protector™ Cuff Pilot™ or LMA Supreme™. Both groups received standard monitoring and induction regimes. Post-insertion, a bronchoscope was used to verify its position. A gastric tube was inserted and OLP was measured. Patients were assessed during the post-operative period for sore throats. Results LMA Protector™ Cuff Pilot™ was comparable to LMA Supreme™ in terms of mean OLP (30.72±8.60 vs 27.23±8.09 cmH(2)O, P = 0.114), first successful attempt (P = 0.312), mean insertion time (27.72±9.45 vs 24.37±6.46 seconds, P = 0.116), and grade 1 laryngeal view (51.7% vs 36.7%, P = 0.244). At first attempt, LMA Protector™ Cuff Pilot™ had a lower success rate of gastric tube insertion than LMA Supreme™ (55.17% vs 96.67%, P <0.001). The incidence of the blood-stained device and sore throat post-operatively were comparable between the two groups. Conclusion LMA Protector™ Cuff Pilot™ was comparable to LMA Supreme™ in terms of overall clinical performance, except for the first successful gastric tube insertion. Improvements should be made to the gastric channel for easier gastric tube insertion in the LMA Protector™ Cuff Pilot™.