Comparison of clinical performance among the I-Gel Proseal Lma and Tulip Oropharyngeal Airway

Supraglottic airway (SGA) devices are widely used to facilitate ventilation during general anesthesia. However, comparative clinical data on different SGA designs remain limited. This study aimed to compare the placement characteristics, clinical performance, and complication profiles of three SGA devices: I-Gel™, the ProSeal™ LMA, and Tulip® Oropharyngeal Airway. This prospective, observational study included 135 adult patients (ASA I–III) scheduled for elective surgery. Three patients were excluded before device placement, leaving 132 patients for analysis. Device selection was based on routine clinical judgment. Failed placements (n = 17) were included in the analysis of placement success and failure rates but excluded from performance-related outcomes such as insertion time and ease of insertion. The primary outcome was insertion time. Secondary outcomes included number of attempts, need for additional maneuvers, hemodynamic parameters, and perioperative complications. Among 132 evaluated placements, the Tulip device demonstrated a significantly higher failure rate compared with I-Gel and ProSeal (25% vs. 5% and 5%, respectively; p = 0.004). Consequently, performance outcomes were analyzed in 115 successfully ventilated patients (I-Gel n = 38, ProSeal n = 38, Tulip n = 39). The Tulip group required a greater number of insertion attempts (p = 0.002). No significant differences were observed between the groups regarding insertion time, ease of insertion, need for maneuvers, hemodynamic variables, or adverse events (p > 0.05). While ProSeal and I-Gel showed comparable clinical performance, the Tulip airway was associated with a higher rate of unsuccessful placement and required more insertion attempts. These findings suggest that device design and operator familiarity may influence placement success. Larger randomized studies are warranted to confirm these results.