Turkish Journal of Geriatrics 2025 , Vol 28, Issue 2
CLINICAL PERFORMANCE COMPARISON OF THE I-GEL AND LARYNGEAL MASK AIRWAY SUPREME IN GERIATRIC PATIENTS: A PROSPECTIVE STUDY
Nursen KARACA1, Işık ALPER1, Özgecan KAYNARCA2
1Ege University Faculty of Medicine, Department of Anesthesiology and Reanimation, Izmir, Turkey
2Republic of Türkiye Ministry of Health Ankara Etlik City Hospital, Department of Anesthesiology and Reanimation, Ankara, Turkey
DOI : 10.29400/tjgeri.2025.435 Introduction: This study compares the clinical performance and pharyngolaryngeal complications of two second-generation supraglottic airway devices, the I-gel and the laryngeal mask airway supreme, in geriatric patients undergoing elective surgery under general anesthesia.

Materials and methods: Following approval from the hospital ethics committee and written informed consent, patients aged 65 years and older, classified with an American Society of Anesthesiologists score of I-III, and scheduled for elective urological surgery under general anesthesia were prospectively included. Participants were randomly allocated into two equalsized groups: I-gel and laryngeal mask airway-supreme. We compared the successful insertion on a first attempt and ease of insertion as a primary outcome, and the secondary outcomes were insertion time, ease of gastric tube insertion, oropharyngeal leak pressure, and intraoperative and postoperative complications.

Results: A total of 120 patients were recruited, with 60 in each group. Insertion time for the supraglottic airway device was significantly shorter in the I-gel group (p<0.001). A greater proportion of patients in the I-gel group demonstrated optimal oropharyngeal leak pressure across all measurement points (p<0.001). However, gastric tube placement was facilitated more easily in the laryngeal mask airway supreme group (p=0.018). Furthermore, intraoperative complications were significantly higher in the laryngeal mask airway-supreme group (p=0.008). No notable differences were detected between the groups regarding ease of insertion, success rate on the first attempt, or postoperative complication rates.

Conclusion: The I-gel may be preferred for geriatric patients due to its shorter insertion time, lower oropharyngeal leak pressure, and reduced incidence of intraoperative complications. Keywords : Physical Functional Performance; Geriatric Anesthesia; Laryngeal Masks