Comparative evaluation of LMA-Supreme and i-gel supraglottic airway devices with endotracheal intubation during surgical correction of traumatic orbital injuries

Aims. The aim of the study was to compare endotracheal intubation with i-gel and LMA (laryngeal mask airway) supreme supraglottic airway devices in orbital osteosynthesis surgery. Methods. 134 patients undergoing orbital plasty after fracture were enrolled in our study and were randomized into three groups: 43 in the endotracheal intubation group, 42 in the LMA-Supreme group, and 49 patients were included in the i-gel group. Hemodynamic parameters, respiratory mechanics, respiration, oropharyngeal leak pressure at different stages of surgical intervention, as well as the time of airway device insertion, the number of attempts and the need for additional maneuvers to insert the airway device were assessed. Findings. In the postoperative period, the assessment of complications associated with the insertion of airway devices was implemented. We did not receive clinically significant differences in mechanical ventilation parameters between groups at the study stages. A reliable difference in oropharyngeal leak pressure at the beginning and at the end of the surgical intervention was obtained. The number of complications was minimal and did not differ between the groups. Conclusion. LMA-S and i-gel supraglottic airway devices allow to provide normal lung ventilation and gas exchange and can be an alternative to endotracheal intubation during orbital osteosynthesis surgery. There is no hyperdynamic response of hemodynamics to insertion of LMA-S and i-gel airway devices in comparison with endotracheal intubation.Herewith, i-gel airway device is the easiest to insert, but in comparison with LMA-S and endotracheal intubation it showed the smallest leak pressure.