Jiancheng dual-channel vs. i-gel laryngeal mask airway for fiberoptic bronchoscopy: A randomized trial.

BACKGROUND

Fiberoptic bronchoscopy (FB) procedures have become increasingly lengthy and complex. Maintaining deep sedation while preventing hypoxemia with conventional oropharyngeal/nasopharyngeal airways presents a significant clinical challenge. Supraglottic airway devices, such as the laryngeal mask airway (LMA), may provide improved oxygenation and procedural efficiency during FB. However, despite the variety of LMA designs, no previous studies have definitively established the optimal type of LMA for FB procedures.

METHODS

96 patients were randomized to either the i-gel LMA group (group I) or Jiancheng dual-channel LMA group (group J). Remimazolam besylate, ciprofol, and sufentanil were used for anesthesia induction and maintenance in both groups. We measured and recorded the success rate of LMA insertion and entering the main airway through the LMA at first attempt, operational interference, mid-procedure LMA adjustments, procedure interruptions, vital signs, and major adverse events.

RESULTS

The patients in group J experienced higher success rates of first-attempt LMA insertion (P < 0.01) and entry into the main airway (P < 0.01) than those in group I. The incidence of coughing was significantly higher in group I than in group J (P < 0.01). The incidence of cardiopulmonary adverse reactions, including respiratory arrest, airway obstruction, airway spasm, laryngospasm, hypertension, and hypotension, was comparable between the two groups. Group I demonstrated a tendency toward prolonged recovery time compared with group J (P = 0.05).

CONCLUSIONS

The Jiancheng dual-channel LMA is associated with higher first-attempt success for airway insertion and bronchoscopy compared to the i-gel LMA, warranting consideration for broader clinical application.

TRIAL REGISTRATION: https://www.chictr.org.cn/showproj.html?proj=265357 (registration no. ChiCTR2500100990, principal investigator: Ru-Ping Dai, date of registration: April 17, 2025).