COMPARATIVE EVALUATION OF AMBU AURA‐I AND FASTRACHTM INTUBATING LARYNGEAL MASK AIRWAY FOR TRACHEAL INTUBATION: A RANDOMIZED CONTROLLED STUDY

Abstract

Background: Supraglottic airway devices (SADs) are critical in airway management, especially in scenarios where tracheal intubation is challenging or impossible. The Fastrach™-laryngeal mask airway (FT-LMA) and Ambu Aura-i are two prominent SADs designed to facilitate both ventilation and tracheal intubation. The FT-LMA, while effective, has limitations such as its rigid airway tube and non-availability for pediatric use. The Ambu Aura-i, with its preformed curvature and availability in various sizes, offers a modern alternative with reported success in difficult airway management. This study aims to comparatively evaluate these two devices in anticipated difficult airway management in adults. Aim: To compare the effectiveness of Fastrach™ LMA and Ambu Aura-i in tracheal intubation in adults with anticipated difficult airway management. Materials and Methods: This randomized, interventional, two-group, comparative prospective clinical study involved 50 adult patients undergoing scheduled surgeries requiring tracheal intubation under general anesthesia. Patients, aged 18 to 60 years, with ASA physical status I or II, were randomly assigned to two groups: Group A (Fastrach™ LMA) and Group B (Ambu Aura-i). Data on success rates, number of attempts, duration of successful attempts, and adverse events were recorded. Hemodynamic parameters were monitored throughout the procedure. xvi Results: Both groups showed comparable baseline characteristics including age, gender distribution, ASA grade, and physical parameters. There was no significant difference in heart rate, systolic and diastolic blood pressure, mean arterial pressure, or oxygen saturation between the groups. However, Group A (Fastrach™ LMA) required significantly shorter tracheal tube insertion time (16.1±2.0 sec vs. 19.1±1.9 sec; p<0.05) and fewer attempts for successful intubation compared to Group B (Ambu Aura-i). The incidence of blood on SAD and sore throat was higher in Group B but not statistically significant. Conclusion: The Fastrach™ LMA demonstrated marginally superior performance over the Ambu Aura-i in terms of shorter tracheal tube insertion times and fewer attempts required for successful intubation. Both devices are effective in managing difficult airways, but the Fastrach™ LMA offers advantages in ease and efficiency, making it a potentially more effective option for critical scenarios requiring rapid and reliable tracheal intubation.