Self-Pressurized Airway Device with Blocker versus Proseal at Different Head and Neck Positions

Abstract

Background: Supraglottic airway devices (SADs) are commonly employed in anesthetic practice due to their ease of placement and ability to secure the airway effectively. Objectives: This study aimed to investigate the influence of various head and neck positions on ventilation parameters when using the Air-Q Self Pressurized Airway Device with Blocker (SP-Blocker) in comparison to the ProSeal Laryngeal Mask Airway (PLMA). Patients and methods: A total of 140 adult female patients (ASA I&II) were included in the final analysis and divided equally permitting 70 patients in each group and scheduled for elective gynecologic laparotomy under general anesthesia. Measurements were initially taken in the neutral head position, followed by flexion, extension, and rotation in a randomized order. The parameters examined were oropharyngeal leak pressure (OLP), peak inspiratory pressure (PIP), expiratory tidal volume (ETV), fiber-optic view score, and ventilation score. Results: In comparison with the neutral position, both devices showed increased OLP and PIP during flexion and reduced values during extension, with minimal differences observed in the rotated position. SP-Blocker demonstrated significantly higher OLP and PIP values than PLMA in both the neutral and flexed positions (p < 0.0001), but lower values in extension (p =0.0006). ETV and ventilation scores remained stable for both devices during flexion, although PLMA was superior in extension (p<0.0001). The SP-Blocker provided better fiber-optic visualization of the glottis in all head and neck positions (p < 0.0001), except during flexion, where visualization was reduced for both devices, with the PLMA showing poorer performance (p=0.0016). Conclusion: Both devices performed adequately during neck flexion; however, PLMA was more effective in maintaining ventilation during neck extension.