COMPARISON OF OROPHARYNGEAL LEAK PRESSURE (OLP) OF I-GEL AND BLOCKBUSTER LMA DURING LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

Background: Supraglottic airway devices (SADs) such as the i-gel and the BlockBuster LMA are widely used in various types of surgeries to provide a secure airway and minimize the complications associated with endotracheal intubation. In laparoscopic cholecystectomy, oropharyngeal leak pressure (OLP) is a key indicator of how well an SAD can maintain a seal under positive pressure ventilation, especially with elevated intra-abdominal pressure during pneumoperitoneum. While several SADs are commercially available, there is a paucity of data comparing the i-gel and the BlockBuster LMA with regard to OLP in laparoscopic cholecystectomy.
Methods: A randomized comparative study was conducted in 70 adult patients (ASA I–II, aged 18–45 years) undergoing elective laparoscopic cholecystectomy under general anesthesia. Participants were allocated into two groups of 35 each: Group I (i-gel) and Group B (BlockBuster LMA). The primary outcome was OLP measured at four time points: (1) 1 minute after SAD insertion, (2) 5 minutes after pneumoperitoneum, (3) 30 minutes after pneumoperitoneum, and (4) 5 minutes after release of pneumoperitoneum. Secondary outcomes included peak inspiratory pressure (PIP), ease and time of insertion, hemodynamic changes, and device-related complications.
Results: The mean OLP values were significantly higher in the BlockBuster LMA group across all four time points compared to the i-gel group (p < 0.001). However, peak inspiratory pressures and hemodynamic parameters did not differ significantly between the groups (p > 0.05). The time to insert the device and the number of insertion attempts were comparable, and both devices demonstrated good airway quality with no clinically significant difference in complications.
Conclusion: The BlockBuster LMA provided higher oropharyngeal leak pressures compared to the i-gel in laparoscopic cholecystectomy. Both devices achieved adequate ventilation and demonstrated comparable safety profiles. The BlockBuster LMA may be preferable in clinical scenarios where higher OLP is desired, although i-gel remains a reliable alternative.