Comparison of Gastric Insufflation Volume Between Ambu AuraGain and ProSeal Laryngeal Mask Airway Using Ultrasonography in Patients Undergoing General Anesthesia: A Randomized Controlled Trial

Introduction: Ambu AuraGain and ProSeal laryngeal mask airway are second-generation supraglottic airway devices (SADs) with added advantage of gastric drain and better oropharyngeal sealing pressure. The primary objective was to study the difference in the gastric insufflation volume between Ambu AuraGain and ProSeal LMA in patients undergoing general anesthesia. Methods: This randomized controlled trial involving 120 adult patients scheduled under general anesthesia were randomized into either Ambu AuraGain or LMA ProSeal group. Gastric cross-sectional area was measured using ultrasonography at baseline, after mask ventilation, and at the end of surgery. Gastric volume was calculated from the measured cross-sectional area. Oropharyngeal sealing pressure, peak airway pressure, and postoperative complications were noted. Statistical analysis was done using SPSS version 22 (Armonk, NY: IBM Corp.) and p < 0.05 was considered statistically significant. Results: Demographic profile of the study groups was comparable. There was a significant difference in gastric volume between the groups at the end of surgery with 5.91 ml (±9.68 ml) in Ambu AuraGain group and 12.28 ml (±13.05 ml) in the LMA ProSeal group (p = 0.001). Similarly, there was a difference in volume between baseline and at the end of the surgery within the groups also (Ambu AuraGain group, p=0.0012; LMA ProSeal group, p=0.0015, respectively). Though the oropharyngeal sealing pressure and peak airway pressures were comparable, increased incidence of postoperative complications was observed with LMA ProSeal. Conclusion: Thus, Ambu AuraGain resulted in a lower gastric insufflation volume than LMA ProSeal with lesser incidence of postoperative complications.