Jump to navigation Teleflex | LMA - Better by Design  Clinical evidence Evidence Search Select product You are here Home › Evidence › Magnetic resonance imaging study of the in vivo position of the extraglottic airway devices i-gel™ and LMA-Supreme™ in anaesthetized human volunteers Magnetic resonance imaging study of the in vivo position of the extraglottic airway devices i-gel™ and LMA-Supreme™ in anaesthetized human volunteers AUTHORS Russo S.G. et al. PUBLICATION Br J Anaesth 2012; 109 (6): 996-1004. SUMMARY A study to compare the in situ position of the LMA Supreme™ and the i-gel™ supraglottic airway devices in anaesthetised volunteers The LMA Supreme™ protruded deeper into the upper oesophageal sphincter than the i-gel™, relative to both the glottis and to the spine OBJECTIVES: To compare the in situ position of the LMA Supreme™ and the i-gel™ supraglottic airway devices in anaesthetised volunteers METHOD: This prospective, randomised, crossover study was undertaken in human volunteers aged >18 years with a body weight of 60-80 kg and normal airways Subjects were American Society of Anesthesiologists physical status 1 During the course of the study, both the LMA Supreme™ and the i-gel™ devices were evaluated in each volunteer in a randomised sequence The position of each device was visualised and compared using magnetic resonance imaging (MRI) of the head and neck, as well as fibre-optic and functional assessments The primary endpoint was the depth that the devices protruded into the upper oesophageal sphincter Other endpoints were The effect of the devices on airway calibre Distortion of other anatomical structures RESULTS: Overall, 6 male and 6 female volunteers were included in the study Subjects had a mean age of 25.8 years and a mean body mass index of 22.5 kg/m2 Fibre-optic and functional assessments showed that the LMA Supreme™ and i-gel™ devices occupied anatomically identical positions, evidenced by Visible vocal cords and arytenoids (with no airway obstruction) in all subjects Device tips located distal to the arytenoids, extending into the hypopharynx Comparable leak pressures (LMA Supreme™, 20 cm H2O; i-gel™, 18 cm H2O) The tip of the LMA Supreme™ protruded significantly (p<0.001) deeper into the upper oesophageal sphincter than the tip of the i-gel™, relative to both the glottis and to the spine (Figure 1) Dilation at the upper level of the upper oesophageal sphincter was significantly less with the LMA Supreme™ than with the i-gel™ (5.13 vs. 5.81 cm2; p=0.009) Dilation at the mid-level of the upper oesophageal sphincter was comparable with the two devices (3.69 vs. 3.79 cm2, respectively; p=0.65) Although both devices had a marked effect on laryngeal structures, compression of the laryngeal inlet was significantly (p=0.005) more pronounced with the LMA Supreme™ versus the i-gel™ (from 0.98 cm [native] to 0.51 cm and 0.62 cm, respectively) A significant (p<0.001) deflection of the epiglottis was observed with both devices (from 180° at baseline to 120° after insertion) The degree of deflection with both devices was comparable despite that the epiglottis was folded into the mask bowl in 1 subject fitted with the LMA Supreme™ and in 11 subjects fitted with the i-gel™ Figure 1. Depth of protrusion of the tip of the LMA Supreme™ and i-gel™ into the upper oesophageal sphincter (data are shown as mean ± standard deviation) * p<0.001 vs. i-gel™ † Distance between the glottis and the distal tip of the device; ‡ Distance between the lower plate of vertebra C5 and the distal tip of the device CONCLUSIONS: Fibre-optic and functional assessments showed that the LMA Supreme™ and i-gel™ devices occupied similar positions in situ in anaesthetised volunteers MRI showed that the LMA Supreme™ protruded deeper into the upper oesophageal sphincter than the i-gel™, relative to both the glottis and to the spine There were significant differences in the effects of the LMA Supreme™ and i-gel™ on adjacent soft tissues and airway calibre Featured evidence 📖 LMA Supreme™, i-gel™ and Laryngeal Tube Suction™ – A prospective, randomized comparative evaluation using fiberoptic and color indicator assessment techniques 📖 Comparison of guided insertion of the LMA ProSeal™ vs the i-gel™ 📖 Magnetic resonance imaging study of the in vivo position of the extraglottic airway devices i-gel™ and LMA-Supreme™ in anaesthetized human volunteers 📖 The LMA Supreme™ – a pilot study 📖 Evaluation of the LMA Supreme™ in 100 non-paralysed patients 📖 LMA Supreme™ – a new single-use LMA™ with gastric access: a report on its clinical efficacy 📖 The Laryngeal Mask Airway Supreme for positive pressure ventilation during laparoscopic cholecystectomy Evidence by category Atomization LMA® Airway Management™ Share this Contact Teleflex Medical Europe Ltd. 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