May 2014 Comparison of the ™ ® new Ambu AuraGain with LMA Supreme New Cuff and Intersurgical i-Gel in Fresh Cadavers Lopez AM, Sala-Blanch X, Valero R and Prats A, D epartment of Human Anatomy, Faculty of Medicine, University H ospital Clinic Barcelona, Spain Background: The Ambu® AuraGain™ is a new phthalate-free single use supraglottic airway device with an incorporated gastric channel and the capability of facilitating optical intubation with a standard endotracheal tube and navigation marks for guiding the flexible scope. The aim of the study was to assess the anatomic fit and performance of the AuraGain™ in fresh cadavers using the Intersurgical i-gel and LMA Supreme New Cuff as comparators. Methods: The three devices were inserted in random o rder in seven fresh cadavers without difficult airway c riteria. The assessed items were: Insertion time, number of attempts, ease of insertion, endoscopic view of vocal cords, a irway seal pressure, anatomic fit by lateral X-ray and neck dissections, and evaluation of functionality of the gastric channel. Moreover, efficacy of guided tracheal intubation through the AuraGain™ and i-gel was investigated. AuraGain™ I-Gel LMA Supreme SGA Insertion time (s) Nº attempts 1/2/3 Ease of insertion: Easy Acceptable Impossible 14(N=14) 5/1/1 17(N=20) 6/-/1 16(N=18) 5/-/2 3 4 0 4 3 0 2 4 1 Gastric tube size Ease of gastric tube insertion: Easy Acceptable Impossible 14G/16G 12G/14G/16G 14 G /16G 7/7 - 1/ 1/NA 2/2/NA - 7/7 - Seal pressure (cm H2O) 25 (8) 26 (8) 23 (4) Flexible scope view Complete vocal cords 6 Epiglottis visible 1 6 1 Only sizes 4, 5 3 1 Intubation time (s) 27 (6) N/A 30 (12) Table 1 Results: Data is shown in table 1. Insertion was s uccessful for all devices within three attempts, except for one case of the LMA Supreme. Lateral X-ray and neck dissections confirmed optimal alignment of all devices with the respiratory and digestive tracts. Endoscopic view was not possible with LMA Supreme size 3, due to design of the device requiring a pediatric flexible scope. Efficacy of gastric channel was superior with AuraGain™ and LMA S upreme as compared to I-Gel, since they both can accommodate larger size gastric tubes. Conclusions: The results of this preliminary study s uggest that the new Ambu AuraGain™ is comparable to the i-gel and LMA Supreme in terms of ease of insertion and the airway seal pressure achieved. However, AuraGain™ was superior to to I-gel and comparable to LMA Supreme in terms of accommodating larger gastric drainage tubes, and allowed intubation of the airway similarly to I-Gel. These preliminary features require further confirmation in clinical trials.