Contrast of oropharyngeal leak pressure and clinical performance of I-gel and LMA ProSeal in patients: A meta-analysis.

BACKGROUND: Conflicting outcomes have been reported for the i-gel and laryngeal mask airway (LMA) ProSeal in children and adults during general anesthesia. Randomized controlled trials (RCTs) that yielded wide contrast outcomes between i-gel and LMA ProSeal were included in this meta-analysis. METHODS: Two authors independently identified RCTs that compared i-gel with LMA ProSeal among patients receiving general anesthesia by performing searches in EMBASE, Cochrane, PubMed, and ScienceDirect. Discussion was adopted to resolve disagreements. Data were counted with Review Manger 5.3 and pooled by applying weighted mean difference (MD) and rlsk ratio (RR), and related 95% confidence intervals. RESULTS: A total of 33 RCTs with 2605 patients were included in the meta-analysis. I-gel provided a considerably lower oropharyngeal leak pressure [weighted average diversity (MD) = -1.53 (-2.89, -0.17), P = 0.03], incidence of blood staining on the supraglottic airway devices [RR = 0.44, (0.28, 0.69), P = 0.0003], sore throat [RR = 0.31 (0.18, 0.52), P<0.0001], and a short insertion time [MD = -5.61 (-7.71, -3.51), P<0.00001] than LMA ProSeal. Compared with LMA ProSeal, i-gel offered a significantly higher first-insertion success rate [RR = 1.03 (1.00, 1.06), P = 0.03] and ease of insertion [RR = 1.06 (1.01, 1.11), P = 0.03]. The gastric-tube-placement first insertion rate [RR = 1.04 (0.99, 1.10), P = 0.11], laryngospasm [RR = 0.76 (0.17, 3.31), P = 0.72], and cough [RR = 1.30 (0.49, 3.44), P = 0.60] between the two devices were similar. CONCLUSIONS: Both devices could achieve a good seal to provide adequate ventilation. Compared with the used LMA ProSeal, the i-gel was found to have fewer complications (blood stainning, sore throat) and offers certain advantages (short insertion time, higher first-insertion success rate and ease of insertion) in patients under general anesthesia.