Fiberoptic Evaluation of i-Gel and Air-Q sp3G Supraglottic Airway Devices in Pediatric Patients

This single-center, prospective, randomized controlled trial will be conducted in pediatric patients aged 1-8 years undergoing elective pediatric or urological surgery under general anesthesia. Participants will be randomized into two groups to receive either an iGel or an Air-Q sp3G device. Device placement will be confirmed intraoperatively via fiberoptic bronchoscopy using a standardized grading system and gastric antral cross-sectional area will be measured with ultrasound before device insertion, immediately after insertion and at the end of surgery to evaluate gastric insufflation.

Secondary outcomes will include postoperative complications such as sore throat, hoarseness, dysphagia, mucosal bleeding, cough, laryngospasm, bronchospasm, nausea, vomiting and stridor. Intraoperative variables such as number of insertion attempts, ease of placement and peak airway pressure will also be recorded. The results are expected to identify which device offers better placement accuracy and lower gastric insufflation rates, thereby improving perioperative safety and postoperative recovery in pediatric patients.

Inclusion criteria

• Age 1-8 years
• ASA I-III
• Elective pediatric or urological surgery under general anesthesia with SGA use
• Informed consent obtained from parents/guardians

Exclusion criteria

• Parental refusal or inability to consent
• ASA > III
• Recent or current upper respiratory tract infection
• History of difficult airway
• Increased aspiration risk
• Urgent/emergency surgery or non-fasted patients
• Known allergy or contraindication to anesthetic agents
• Severe asthma (attack within last 6 months)
• Structural airway anomalies
• Gastrointestinal pathology affecting stomach emptying
• Previous stomach surgery