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Oropharyngeal Leak PressureNCT06914453

A Randomised Controlled Trial to Compare Two Supraglottic Airway Devices (Ambu AuraGain vs Air Q-3) in Terms of Performance Characteristics.

A study testing Air Q-3 Supraglottic Airway Device and Ambu AuraGain Supraglottic Airway Device in people with Oropharyngeal Leak Pressure and Supraglottic Airway, run by University of Malaya at 1 site in Malaysia.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

A supraglottic airway device (SAD) functions as a temporary device to maintain the patency of airway during the administration of anaesthesia. The Ambu AuraGain (Ambu, Ballerup, Denmark) is a second generation SAD, since introduced in 2014, has been widely used in clinical practice. Read more about this study

Who is it for?
Ages 18 to 65 yearsHealthy volunteers can take part
What is being tested?
Air Q-3 Supraglottic Airway Device and Ambu AuraGain Supraglottic Airway Device
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
90 participants
Where
1 siteMalaysia
Study dates
26 Jul 2024to 24 Jan 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Adult patients (age 18 to 65 years) of either sex, who are scheduled for an elective surgery under general anaesthesia
  • Patients with ASA physical status of I or II.

Who cannot join

  • Patients with anticipated difficult airway (Airway Difficulty Score >8)
  • Patients with high risk of aspiration and regurgitation
  • Patients with body mass index (BMI) > 40kg/m2
  • Patients who exhibit evidence of upper respiratory tract infection
  • Patients with history of radiotherapy to the neck
  • Patients who are pregnant
Show all 9Show fewer
  • Patients who are unable or unwilling to consent for the study
  • Patients who are mentally challenged and unable to understand the study instructions
  • Planned operating time more than 4 hours

Trial locations and contacts

1 site in 1 country.

Malaysia1 site
  • Department of Anaesthesiology, Faculty of Medicine

    Kuala Lumpur, Selangor, 50603

Other trials in Malaysia

About this study

Official title: A Comparative Study of Air-Q3 and Ambu AuraGain Supraglottic Airway Device in Patients Undergoing Elective Surgery Under General Anaesthesia: A Randomised Controlled Trial

A supraglottic airway device (SAD) functions as a temporary device to maintain the patency of airway during the administration of anaesthesia. The Ambu AuraGain (Ambu, Ballerup, Denmark) is a second generation SAD, since introduced in 2014, has been widely used in clinical practice. The Ambu AuraGain is an anatomically curved, single-use supraglottic airway device that features a port for orogastric tube insertion and it is a conduit for intubation as well. It is also associated with fast insertion times and high seal pressures. The Air-Q3, on the other hand, is relatively new SAD, however rather similar to Ambu AuraGain, it is also anatomically curved with a built-up mask heel for improved seal and it serves as a conduit for intubation as it features a unique endotracheal tube ramp and epiglottis elevator which aids in fast easy and safe intubation. It also features a port for orogastric tube insertion. Given the relatively recent introduction of the Air-Q3 into the market, there exists a paucity of comprehensive data regarding its efficacy. Meanwhile, the Ambu AuraGain stands as one of the most frequently utilised SAD, especially in our centre. This randomized controlled trial aims to compare the performance characteristics of the Ambu AuraGain and Air Q-3 in 90 patients undergoing surgery under general anaesthesia. The primary objective is to evaluate oropharyngeal leak pressure (OLP), while secondary objectives includes time to insertion, first-pass success rate, ease of orogastric tube (OGT) insertion, laryngeal alignment using a fiberoptic scope, and incidence of postoperative complications.

Read the detailed description

Preoperative assessment, encompassing history taking, physical examination, laboratory investigation, and a comprehensive explanation of the study, will be conducted the day prior to surgery. Patients will be instructed to fast for 6 hours for solid foods and 2 hours for clear fluids before elective surgery.

Patients will be randomly allocated to either the Air-Q3 group (n = 45) or the Ambu AuraGain group (n = 45) using a computer-generated randomization table. After recruitment, the enrolling investigator opens the sealed opaque envelopes that concealed group allocation. Patients will be blinded to their group allocation. Patients will not receive any premedication and will be positioned supine on the operating table, head in neutral position, rested on a gel head ring. Standard monitoring including basic physiological variables, including electrocardiography, pulse oximetry, non-invasive blood pressure monitoring, and end-tidal oxygen measurement using a circle circuit ventilator (Datex Ohmeda, Aespire, Marquet), will be performed prior to anaesthesia induction.

Following establishment of intravenous access, a standard anaesthesia induction protocol will be followed, involving preoxygenation with 100% inspired oxygen for 3 minutes, intravenous administration of Fentanyl (1-2mcg/kg), and Propofol (2-3mg/kg) until loss of consciousness. Subsequently, either the Air-Q3 or Ambu AuraGain will be lubricated and prepared according to manufacturers' recommendations. The airway device will be inserted when the jaw is sufficiently relaxed. The cuff of each device will be inflated with air to a final cuff pressure of 60cmH20. The cuff pressure is measured by a handheld manometer, The airway device insertions will be performed by experienced staff anaesthesiologists with more than ten years experience with supraglottic airway management, who had performed at least 10 Air-Q3 insertions prior to trial commencement.

SAD size selection will adhere to manufacturers' recommendations based on the patient's ideal body weight. Insertion time will be recorded from facemask removal until the presence of square wave capnography tracing. The presence of square wave capnography tracing denotes successful establishment of effective ventilation. Otherwise, the device will be removed completely for another insertion attempt. Failure to insert the SAD after two attempts will be deemed a failure.

After successful insertion of the airway device, it will be secured with tape over the patient's check. A gel plug is applied to the orogastric port and a suprasternal notch test (gentle tapping over the suprasternal notch results in the gel to pulsate, confirming tip location behind the cricoid cartilage) will be done to confirm placement. A 14 French gauge gastric tube, pre lubricated with a water soluble lubricant will be inserted through the nasogastric port for both devices. The ease of insertion will be graded from 1 to 3 (1 = easy, 2 = difficult, 3 = impossible). After successful insertion of the airway device, it will be secured with tape over the patient's check. A gel plug is applied to the orogastric port and a suprasternal notch test (gentle tapping over the suprasternal notch results in the gel to pulsate, confirming tip location behind the cricoid cartilage) will be done to confirm placement. A 14 French gauge gastric tube, pre lubricated with a water soluble lubricant will be inserted through the nasogastric port for both devices. The ease of insertion will be graded from 1 to 3 (1 = easy, 2 = difficult, 3 = impossible). Confirmation of correct orogastric tube placement will be established through aspiration of gastric contents or epigastric auscultation.

Oropharyngeal leak pressure will be determined by transiently halting ventilation and closing the adjustable pressure limiting valve up to 30cmH2O with a fresh gas flow of 3L/min. The airway pressure at equilibrium or when audible air leak is heard from the throat is recorded.

Following successful SAD insertion, fibreoptic scope assessment will be conducted to evaluate LMA placement, graded based on the standardized scale by Brimacombe:

  1. Vocal cords not seen
  2. Vocal cords plus anterior epiglottis visible
  3. Vocal cords plus posterior epiglottis visible
  4. Only vocal cords visible Maintenance of general anaesthesia will be with sevoflurane with minimum alveolar concentration 1 - 2 in an oxygen-air mixture.

Postoperatively, patients will be monitored in the recovery room, with physiological variables including non-invasive blood pressure, heart rate, pulse oximetry, and respiratory rate continuously monitored. Upon full consciousness and recovery, a blinded investigator will assess for the presence of sore throat.

Being tested
Air Q-3 Supraglottic Airway Device, Ambu AuraGain Supraglottic Airway Device
Keywords
Ambu AuraGain, Supraglottic Airway Device, General Anaesthesia, Oropharyngeal leak pressure, Laryngeal Alignment, Air-Q3

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Air Q-3 Supraglottic Airway DeviceDevice

    Oropharyngeal leak pressure and other performance characteristics including time to insertion, first-pass success rate, ease of orogastric tube (OGT) insertion, laryngeal alignment using a fiberoptic scope, and incidence of postoperative sore throat.

  • Ambu AuraGain Supraglottic Airway DeviceDevice

    Oropharyngeal Leak Pressure and other performance characteristics including time to insertion, first-pass success rate, ease of orogastric tube (OGT) insertion, laryngeal alignment using a fiberoptic scope, and incidence of postoperative sore throat.

Study groups in NCT06914453
Study groupRoleWhat they receive
Ambu AuraGainActive comparatorPatients in this group, once under general anaesthesia, will have this supraglottic airway device inserted to maintain airway patency and maintenance of general anaesthesia.
Receives: Device: Ambu AuraGain Supraglottic Airway Device
Air Q-3Active comparatorPatients in this group, once under general anaesthesia, will have this supraglottic airway device inserted to maintain airway patency and maintenance of general anaesthesia.
Receives: Device: Air Q-3 Supraglottic Airway Device

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Oropharyngeal leak pressure (OLP) of the Air-Q3 and Ambu AuraGain supraglottic airway device

    After induction of general anaesthesia, either one supraglottic airway device will be inserted, Oropharyngeal leak pressure will be determined by transiently halting ventilation and closing the adjustable pressure limiting valve up to 30cmH2O with a fresh gas flow of 3L/min. The airway pressure at equilibrium or when audible air leak is heard from the throat is recorded.

    Measured: After induction of general anaesthesia until successful insertion of supraglottic airway device

Secondary outcomes (3)
  1. Other performance characteristics in terms of time to insertion, first pass success rate, ease of orogastric tube (OGT) insertion.

    Time of insertion will be recorded during the insertion of the airway device, the number of attempts to successful insertion will also be recorded. The ease of insertion of gastric tube will be graded from 1 to 3 (1 = easy, 2 = difficult, 3 = impossible).

    Measured: After induction of anaesthesia until comfirmation of correct orogastric tube placement will be established through aspiration of gastric contents or epigastric auscultation

  2. Laryngeal alignment using fibreoptic scope by employing the standardised scale developed by Brimacombe

    Following successful SAD insertion, fibreoptic scope assessment will be conducted to evaluate LMA placement, graded based on the standardized scale by Brimacombe:

    1. Vocal cords not seen
    2. Vocal cords plus anterior epiglottis visible
    3. Vocal cords plus posterior epiglottis visible
    4. Only vocal cords visible

    Measured: After insertion of supraglottic airway device till performing fibreoptic scope assessment

  3. Incidence of complications of using both SADs such as post operative sore throat

    Post extubation, patient will be assessed for presence of sore throat

    Measured: From extubation until full consciousness in recovery area

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Apr 2025
  2. Study start26 Jul 2024
  3. Primary completion24 Jan 2025
  4. Study completion24 Jan 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Model description
Two Types of Supraglottic Airway Devices (Ambu AuraGain and Air Q-3) are involved. A total of 90 patients will be randomised using a computer-generated randomisation table to either receive Air-Q3 or Ambu AuraGain. 45 patients in each group
Masking
Single blind
Who is masked
Participant
Enrolment
90 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06914453
Sponsor's protocol ID
UMalaya (MREC 2024426-13665)
Status last verified
Mar 2025
First submitted
31 Mar 2025
Last updated
9 Apr 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Gupta R, Mahajan R, Jatinder M, Gulati S, Mehta A, Nazir R. A comparison between ProSeal laryngeal mask airway and Air-Q Blocker in patients undergoing elective laparoscopic cholecystectomy. J Anaesthesiol Clin Pharmacol. 2019 Jul-Sep;35(3):340-347. doi: 10.4103/joacp.JOACP_397_17.

    PubMed 31543582
  • Preece G, Ng I, Lee K, Mezzavia P, Krieser R, Williams DL, Stewart O, Segal R. A randomised controlled trial comparing fibreoptic-guided tracheal intubation through two supraglottic devices: Ambu(R) AuraGain laryngeal mask and LMA(R) Fastrach. Anaesth Intensive Care. 2018 Sep;46(5):474-479. doi: 10.1177/0310057X1804600508.

    PubMed 30189821
  • Singh A, Bhalotra AR, Anand R. A comparative evaluation of ProSeal laryngeal mask airway, I-gel and Supreme laryngeal mask airway in adult patients undergoing elective surgery: A randomised trial. Indian J Anaesth. 2018 Nov;62(11):858-864. doi: 10.4103/ija.IJA_153_18.

    PubMed 30532321
  • Shariffuddin II, Teoh WH, Tang E, Hashim N, Loh PS. Ambu(R) AuraGain versus LMA Supreme Second Seal: a randomised controlled trial comparing oropharyngeal leak pressures and gastric drain functionality in spontaneously breathing patients. Anaesth Intensive Care. 2017 Mar;45(2):244-250. doi: 10.1177/0310057X1704500215.

    PubMed 28267947
  • Che Omar S, Hardy Mohamad Zaini R, Fui Wong T, Nazaruddin W Hassan WM. Comparison of the Air-Q intubating laryngeal mask airway and the Ambu AuraGain laryngeal mask airway as a conduit for fibreoptic assisted endotracheal intubation for simulated cervical spine injury. Anaesthesiol Intensive Ther. 2021;53(3):241-245. doi: 10.5114/ait.2021.105759.

    PubMed 34006053
  • Jindal S, Mittal A, Anand LK, Singh M, Kapoor D. Comparative evaluation of Air-Q blocker and Proseal laryngeal mask airway in patients undergoing elective surgery under general anaesthesia: A randomised controlled trial. Indian J Anaesth. 2021 Mar;65(Suppl 1):S20-S26. doi: 10.4103/ija.IJA_1254_20. Epub 2021 Mar 20.

    PubMed 33814586
  • Brimacombe J, Berry A. A proposed fiber-optic scoring system to standardize the assessment of laryngeal mask airway position. Anesth Analg. 1993 Feb;76(2):457. No abstract available.

    PubMed 8424538

Questions about this trial

What is this clinical trial studying?

A study testing Air Q-3 Supraglottic Airway Device and Ambu AuraGain Supraglottic Airway Device in people with Oropharyngeal Leak Pressure and Supraglottic Airway, run by University of Malaya at 1 site in Malaysia.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 9 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Malaysia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Oropharyngeal leak pressure (OLP) of the Air-Q3 and Ambu AuraGain supraglottic airway device (time frame: After induction of general anaesthesia until successful insertion of supraglottic airway device). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06914453, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Apr 2025.

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