A randomised controlled trial to compare blind intubation success through LMA Blockbuster® and I-Gel® LMA

Introduction:
Laryngeal mask airway-blockbuster (LMA-BT) is a relatively new supraglottic airway device (SGAD). In this study, we compared LMA-BT with I-Gel LMA for efficacy of blind tracheal intubation.

Material and methods:
We conducted a single-blind prospective study after ethical approval. One hundred American Society of Anesthesiology (ASA) Grade I–III (age 18–60 years) patients scheduled for elective surgery under general anaesthesia with endotracheal intubation were included and randomly divided into 2 groups. Blind tracheal intubation was performed through LMA-BT (n = 50) and I-Gel (n = 50) in groups 1 and 2, respectively. The primary aim was to evaluate the first pass success rate of blind tracheal intubation through the LMAs. The secondary objectives noted were attempts and ease of LMA insertion, total time taken for LMA insertion, airway seal pressure of LMA, ease of NGT insertion through LMA, fibre-optic grading of laryngeal view through LMA, overall success rate and time of intubation through LMA, time for LMA removal, and complications, if any.

Results:
In the LMA-BT group, the first pass success rate (P < 0.019) and the overall success rate of intubation (P < 0.005) were significantly higher than in the I-Gel group. Using LMA-BT also resulted in statistically significant shorter intubation time (P < 0.0001) with higher airway seal pressure as compared to I-Gel (P < 0.001). The difference in the first attempt insertion, number of insertion attempts, ease and time of LMA insertion and removal after intubation, and postoperative complications were comparable among the groups.

Conclusions:
LMA-BT is a superior device as compared to I-Gel LMA as a conduit for blind tracheal intubation.