The Effectiveness of Airway Devices Study


In order to compare the effectiveness of the two airway devices, the IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) published a study by eminent authors titled “A Prospective, Randomized, Comparative Study of Ease of Insertion of Laryngeal Mask Airway classic and I-Gel Supra Glottic Airway Devices in Anaesthetized, Adult Patients.” The authors justify the title and highlight the major point of comparing two supraglottic devices’ performance, provided in the article’s abstract. The abstract summarizes the background, objectives, methodology, discussion results and conclusion of the observational data of the research.

Analyzing the qualifications of the authors of the article, one can clearly understand that they are competent enough to conduct such a study; Dr. S Sreenivasarao is an Assistant Professor in the Department of Anaesthesia, Dr. S Seshaiah is an Associate Professor in the Department of Anaesthesia, and Dr. K Faheem is an Assistant Professor of Department of Anaesthesia. This essay critiques the article utilizing Caldwell, Henshaw and Taylor’s (2011) critiquing quantitative data framework as a guide to assess the expertise of an operating department practitioner in relation to an area of perioperative care and the application of evidence-based practice in the perioperative setting.


Different airway devices are used to maintain the airway during general anesthesia. The i-gel and Laryngeal Mask Airway classic (LMA-classic) are some of the supraglottic airway devices used for this purpose. Sreenivasarao et al. (2019) conducted a comparative study to investigate the safety and effectiveness of these two devices and determine which is superior to the other. The article is divided into six parts: introduction, objectives, methodology, results, discussion, and conclusion. The introduction provides a background of the study, where the authors acknowledge that the devices in question have been studied superlatively, and no one has ever taken the initiative to compare them. The aim and parameters integral to the safety and effectiveness of LMA-classic and I-gel are outlined in the objective section. The methodology indicates approaches used to recruit participants, collect information and analyze data. Participants were randomly selected; data was collected through observation, and regression analysis was used to analyze the latter.

Tables were used to present the results, making comparing the two devices used in the study easier. The article’s findings note that the difference in ease and the number of insertion attempts were not statistically significant. Additionally, the authors found no statistically significant differences in postoperative complications and hemodynamic changes between LMA-classic and i-gel. However, a statistically significant difference was evident in the meantime of insertion (higher for LMA-classic) and average airway leak pressure (higher in i-gel). The authors concluded that the two devices could safely and effectively provide airways during positive pressure ventilation.


The article titled “A Prospective, Randomized, Comparative Study of Ease of Insertion of Laryngeal Mask Airway classic and I-Gel Supra Glottic Airway Devices in Anaesthetized, Adult Patients” clearly reflects the content provided by the authors. The content focuses on two supraglottic airway devices in the introduction, methodology, discussion, and conclusion. Additionally, the article only studies and discusses the adult population as indicated on the topic.

The authors, Dr. S Sreenivasarao, Dr. S Seshaiah and Dr. K Faheem, are credible. Their titles prove they have adequate academic qualifications to do research and make appropriate conclusions and recommendations based on the obtained findings. Additionally, they are all professionals based on the department which the study article explores. Dr. S Sreenivasarao and Dr. K Faheem are Assistant Professors in the Department of Anaesthesia and pathology, respectively. Equally, Dr. S Seshaiah is an Associate Professor in the Department of Anaesthesia. Other studies conducted by the authors further reinforce their credibility. For instance, Dr. S Sreenivasarao and Dr. S Seshaiah are the authors of “A Prospective Randomised Comparative Study of 0.5% Heavy Bupivacaine 15mg With 0.9% Saline AND 0.5% Heavy Bupivacaine 15mg WITH 2mg Midazolam Intrathecally in Lower Abdominal Surgeries and Lower Limb Surgeries.”

The abstract summarizes the key components of the study in an organized way. Dr. S Sreenivasarao et al. (2019) divided the abstract into four sections: background and objectives, methodology, results, and interpretation and conclusion. This approach makes it easier for readers to capture everything covered in the article at a glance without needing to read it in detail. Each of the four parts outlined in the abstract is concise and clear.

Sreenivasarao et al. (2019) clearly outlined the research’s rationale. The introduction noted that the two supraglottic airway devices are commonly used for surgical procedures requiring general anesthesia to alleviate the possibility of complications associated with tracheal intubation. Therefore, comparing LMA-classic and i-gel was vital in determining which is superior over the other. As a result, the findings would promote evidence-based practice among healthcare professionals when choosing a device to use for tracheal intubation. However, the authors did not clearly mention the latter in the article.

The article’s literature review is less comprehensive and not well organized. The nature of the study conducted in the article requires a more detailed literature review. Although Sreenivasarao et al. (2019) identified the gap in previous studies, they just highlighted it without indicating possible contributing factors. The literature is not organized because it is hard to identify which study was conducted, the findings, and the gap. Instead, studies reviewed in the literature were tacked in one paragraph. Another shortcoming of the literature review is that it is not up to date. Out of the eleven studies referenced in the section, only three were published within ten years, meaning that most of the information was outdated. Nevertheless, the literature review sets the background for stating the aim of the study.

Sreenivasarao et al. (2019) clearly stated the aim of undertaking the research. The aim was to evaluate and compare i-gel and LMA-classic supraglottic airway devices in adult patients undergoing elective surgeries under general anesthesia. The authors’ focus areas included ease of insertion, number of insertion attempts, and time for insertion, airway leak pressure, hemodynamic changes and oxygen saturation. The authors equally assessed adverse effects such as postoperative dysphagia or sore throat and dental, lip, or tongue trauma associated with usage of the devices.

Although several ethical issues are associated with this type of study, the authors failed to identify them clearly. Possibly, they assumed that the readers knew the ethical issues and went on to outline how they addressed some of them. They only indicated that they obtained clearance and informed consent from the ethical committee and participants, respectively. Important ethical issues that should have been clearly outlined and how to address them include voluntary participation, informed consent, potential harm, confidentiality, and anonymity. Unfortunately, Sreenivasarao et al. (2019) presumed that the readers who know the ethical issues will be able to identify approaches taken to address them as they go through the study.

Sreenivasarao et al. (2019) identified the methodology they used in the study. The methodology is a prospective randomized comparative study of easy insertion of laryngeal mask airway and Igel supraglottic airway devices in anesthetized adult patients. The study’s participants were randomly divided into two equal groups comprising fifty adults. However, the authors did not take any step to justify the methodology they used.

The study design applied by Sreenivasarao et al. (2019) is clearly identifiable. The authors used a quantitative research design, portrayed by various features in the article. For instance, Sreenivasarao et al. (2019) used numbers and tables as a form of expression. They also used statistical analysis to compare the two supraglottic airway devices. Although the authors did not state the rationale for choosing the study design, the reason is evident because the research involves comparing two devices. Therefore, the variables must be quantified, statistically analyzed, and presented to achieve the desired objectives. Most clinical studies focus on testing one or several hypotheses. For this article, the authors aimed to compare i-gel and LMA-classic supraglottic devices and determine which is superior to the other. While several parameters were studied, the authors did not state any experimental hypothesis.

Clearly identified study variables allow readers to follow an article and understand the findings and conclusions. However, Sreenivasarao et al. (2019) evidently outlined and categorized the variables of their study as dependent or independent. The burden was left to readers to decide the dependent and independent variables. For this study, the safety and effectiveness of i-gel and LMA-classic supraglottic devices (as noted in the conclusion) were supposed to be the dependent variables. On the other hand, the independent variables were the parameters studied, including ease of insertion, the number of insertion attempts, time for insertion, airway leak pressure, and hemodynamic changes, oxygen saturation, and postoperative complications.

The article identified the targeted population and adequately described the sample. The population comprised normotensive adult patients, both males and females, aged between 18 and 50 years. Additionally, patients must undergo elective surgical procedures under general anesthesia with controlled ventilation. The sample size for the population was one hundred participants, who were divided randomly into two equal groups of fifty patients. Group 1 comprised patients using i-gel and group 2 LMA-classic supraglottic devices. The age distribution was as follows: below 20 years ten patients, 21-30 years 23 patients, 31-40 years 21 patients, 41-50 years 46 patients (Sreenivasarao et al., 2019). The number of female participants was 84, and that of males 16 patients.

The method of data collection and data analysis influence the obtained findings. The approaches used by Sreenivasarao et al. (2019) to collect and analyze data were valid and reliable. The medical practitioners observed and recorded all the information related to the studied parameters, minimizing the possibility of having biased data and findings. Notably, observation is one of the methods used to collect information in studies. Sreenivasarao et al. (2019) based their data analysis on statistical methods applied to previous studies on i-gel and LMA-classic. Although not clearly indicated in the article, the authors used the regression method to analyze the collected data and presented them in tabular form.

Sreenivasarao et al. (2019) presented the results appropriately and clearly, making it easier for the readers to understand. They used table 1 to table 11 to present the collected results of the analyzed data. This approach is the best, especially where two dependent variables are compared. In the study, the authors compare the effectiveness and safety of i-gel and LMA-classic based on various parameters noted earlier. The results are described as highly statistically significant (p<0.01), statistically significant (p<0.05), and not statistically significant (p>0.05). For example, tables 6 and 7 show that the difference in mean duration for insertion and airway leak pressure for i-gel and LMA-classic were highly statistically significant.

The part of research study is comprehensive since it elaborates the findings in detail. Sreenivasarao et al. (2019) discussed each of the studied parameters separately. The discussion is clear and well-articulated, making it easier for the readers to follow and understand. The authors compare their findings with the results of previous studies, most of which support the former. For example, Sreenivasarao et al. (2019) note that their findings regarding insertion were similar to Richez B et al.’s study at 93% for very easy. Equally, their findings of postoperative complications were consistent with that of “Siddiqui AS et al., Helmy AM et al., and Fanksen H et al.” The comparison of the study’s results with other researchers enhances their validity.

The results of the study cannot be generalized due to various reasons. The first reason is the population used, adults aged between 18 and 50 years. It would be wrong to assume that the children, teenagers and geriatric population would portray similar results. Additionally, conflicting findings are possible among patients undergoing surgical procedures taking more than 60 minutes with or without general anesthesia. The second reason is the sample size used, 100 participants, which is too small to generalize the findings (Sreenivasarao et al., 2019). Therefore, a similar study with a larger sample size with proportional males and females is necessary to generalize such results. Lastly, the study did not consider lifestyle factors such as smoking and alcohol consumption, which can influence postoperative complications.

However, the results are transferrable in terms of the safety and effectiveness of i-gel and LMA-classic supraglottic devices. The findings can be applied in other contexts and situations where the patient’s studied population has different health conditions. Equally, the safety aspect of the devices is applicable all the time and to different populations, such as older adults and teenagers. The study’s conclusion is not comprehensive because the authors did not consider limitations that may have impacted the findings. They briefly stated the safety and effectiveness of the supraglottic airway devices without explaining.

The study’s objectives were met; however, some factors have negatively impacted the quality of the research article. Sreenivasarao et al. (2019) failed to outline any assumptions they made when choosing the research design and methodology and making conclusions about their findings. They also overlooked important ethical issues and how to address them. For instance, it was unclear whether the participants were allowed to opt out of the study at any time. The authors did not provide a clear theoretical framework for the study.

Moreover, the authors did not indicate any limitations related to their study. Notably, any research is bound to have some limitations at some point, for example, in the data collection method or data analysis. Therefore, it was wrong for the authors to assume that the findings were all-inclusive, bearing in mind that the sample size was only one hundred participants within given age groups. Further, they assumed their findings were final because they did not recommend further studies with different populations or larger sample sizes. In most cases, researchers acknowledge that limitations are inevitable and the possibility of getting differing results when population, sample size, or settings, among other factors, are changed.

Another factor that hurt the quality of the article is the mixing of plural and singular when refereeing to the participants and the lack of space between some words. For instance, the authors introduced the participants as “All patients…were pre-medicated…,” on page 28. However, they changed it to “…patient was paralyzed…was masked…,” as they continued developing the paragraph (Sreenivasarao et al., 2019). Spacing between words lacking in “Both deviceswere….asrecommended by manufacture…,” and throughout the paper (Sreenivasarao et al., 2019). These inconsistencies make it hard for the reader to follow the content of the article and lower the latter’s quality.


LMA-classic and I-gel are instrumental supraglottic airway devices that are safe and effective for patients undergoing surgical procedures with general anesthesia. Although most of the parameters studied in this article show that the differences between the two devices are not statistically significant, i-gel provides a better airway sealing pressure than LMA-classic. The research is important because the findings can help healthcare practitioners such as anesthesiologists choose the appropriate supraglottic airway device. Further research using a larger sample size or different populations is necessary to determine whether the findings are consistent or not or apply to all patients.


Caldwell, K., Henshaw, L., & Taylor, G. (2011). Developing a framework for critiquing health research: An early evaluation. Nurse Education Today, 31(8), 1-7.

Sreenivasarao, D., Seshaiah, D., & Faheem, D. (2019). A prospective, randomized, comparative study of ease of insertion of laryngeal mask airway classic and igel supraglottic airway devices in anesthetized adult patients. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS), 8(4), 26-35.

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NursingBird. "The Effectiveness of Airway Devices Study." April 17, 2023.