Comparison of oropharyngeal leak pressure and clinical performance of LMA ProSeal™ and i-gel® in adults: Meta-analysis and systematic review

Background: A meta-analysis and systematic review of randomized controlled trials to compare the oropharyngeal leak pressure (OLP) and clinical performance of LMA ProSeal™ (Teleflex® Inc., Wayne, PA, USA) and i-gel® (Intersurgical Ltd, Wokingham, UK) in adults undergoing general anesthesia. Methods: Searches of MEDLINE®, EMBASE®, CENTRAL, KoreaMed and Google Scholar® were performed. The primary objective was to compare OLP; secondary objectives included comparison of clinical performance and complications. Results: Fourteen RCTs were included. OLP was significantly higher with LMA ProSeal™ than with i-gel® (mean difference [MD] −2.95 cmH₂O; 95% confidence interval [CI] −4.30, −1.60). The i-gel® had shorter device insertion time (MD −3.01 s; 95% CI −5.80, −0.21), and lower incidences of blood on device after removal (risk ratio [RR] 0.32; 95% CI 0.18, 0.56) and sore throat (RR 0.56; 95% CI 0.35, 0.89) than LMA ProSeal™. Conclusion: LMA ProSeal™ provides superior airway sealing compared to i-gel®.