Comparison of the clinical performance of i-gel and Ambu laryngeal masks in anaesthetised paediatric patients: A meta-analysis

Table 1 Description of the included trials comparing Ambu and i-gel values are presented as numbers, mean ± SD, or median (interquartile range)

Ref.	Airway (intervention)	n	Airway size	Age (yr or mo)	Weight (kg)	OLP measurement method	Type of surgery	Ventilation	NBD	Depth of anesthesia for laryngeal mask placement and the proficiency of anesthesiologists	Primary outcomes
Theiler et al[9] (2011)	Aura once	102	Size 1.5 (5-9.9 kg); Size 2 (10-19.9 kg); Size 2.5 (20-29.9 kg); Size 3 (30-50 kg)	6.2 ± 4.0 yr	24.7 ± 11.6	Manometric stability	Elective day surgery under general anaesthesia (urology, orthopaedics, visceral, dermatology)	Mechanical	No	Absence of motor and cardiovascular responses to the jaw thrust maneuver; anesthesiology staff at the University Hospital Bern	OLP
	I-gel	106	Size 1.5 (5-9.9 kg); Size 2 (10-24.9 kg); Size 2.5 (25-34.9 kg); Size 3 (35-50 kg)	6.3 ± 3.7 yr	24.7 ± 11.2
Gu et al[22] (2016)	AuraOnce	32	Size 2	29.28 ± 11.32 mo	13.78 ± 2.55	NR	Elective hypospadias repair surgery	Mechanical	No	After the eyelash reflex disappeared and the mandibularjoint loosened; NR	OLP and respiratory dynamic data
	I-gel	32		26.72 ± 12.16 mo	13.95 ± 2.87
Alzahem et al[17] (2017)	Auraonce	48	NR	32.3 ± 38 mo	13.2 ± 8.3	Noise detection	Elective surgery	Mechanical	No	Lack of a motor response to jaw thrust; had more than 20 years’ experience in the specialty and more than 1000 successful insertions of these SGADs	OLP
	I-gel	64		30.6 ± 37.4 mo	12.7± 8.2
Aqil et al[18] (2017)	Auraonce	30	Size 1.5/2/2.5/3	4.62 ± 2.85 yr	18.28 ± 7.23	Noisedetection	3D-MRI of the head and neck	Spontaneous breathing	No	NR
	I-gel	29		4.76 ± 3.18 yr	17.66 ± 7.47
Lee et al[14] (2019)	Auragain	29	Size 1.5 (5-10 kg); Size 2 (10-20 kg); Size 2.5 (20-30 kg)	1.5 (0.75-5) yr	12.2 (9.4-21.8)	Stethoscopic noise	Elective surgery	Mechanical	Yes	Muscle relaxation with rocuroniumand mask ventilation for 90 s; experienced anaesthesiologists	Safety margin
	I-gel	30	Size 1.5 (5-12 kg); Size 2 (10-25 kg); Size 2.5 (25-35 kg)	3 (0.75-6) yr	13.9 (10.2-23.4)
Kim et al[15] (2019)	Auragain	34	Size 1.5 (5-9.9 kg); Size 2 (10-20 kg)	23.5 ± 17.8 mo	11.6 ± 3.3	Manometric stability	Upper-/lower-extremity surgery under general anaesthesia	Mechanical	No	Absence of motor and cardiovascular responses to the jaw thrust maneuver; skilled and vastly experienced at inserting supraglottic airway devices	Requirement for additional airway manoeuvres
	I-gel	33		15.6 ± 11.5 mo	10.5 ± 2.4
Mihara et al[19] (2019)	Auragain	48	Size 1.5/2.0/2.5	42 (14-66) mo	14.4 ± 5.0	Manometric stability	Elective surgery with an expected surgery time of < 2 h	Mechanical	No	Lack of a motor response to jaw thrust; had experience of SGA insertion of more than 20 times	OLP
	I-gel	50		42 (14-66) mo	13.7 ± 5.4

MRI: Magnetic resonance imaging; OLP: Oropharyngeal leak pressure; SGADs: Supraglottic airway devices; NBD: Neuromuscular blocking agent; NR: Not reported.