Comparison of Efficacy of LMA Cuff Pressure Measurement: AG Cuffill vs CuffSure in Paediatric Population under General Anaesthesia

Dr. Apurva Agarwal, Dr. Pushpendra Kumar Saini, Dr. Veena Arora, Dr. Chandra Shekhar Singh, Dr. Neha Mishra

Abstract: Background and Aims: Laryngeal mask airways (LMA) are widely used in paediatric anaesthesia, but excessive cuff pressure (>30-40 cmH?O) can cause mucosal ischemia and post-operative throat morbidity. Despite these risks, routine cuff manometry is uncommon. We aimed to compare two cuff pressure measuring devices-the digital AG Cuffill and the analogue CuffSure (Tuoren)-for efficacy in controlling LMA intracuff pressure in children under general anaesthesia with controlled ventilation. We hypothesized that CuffSure would better maintain optimal cuff pressures, improve ventilation and reducing complications. Methods: In this prospective randomized comparative study, 150 paediatric patients (weight 10-30 kg) undergoing elective surgery with LMA were divided into three equal groups. In Control (no manometer), LMA cuffs were inflated by standard volume (per manufacturer?s guidelines). In AG Cuffill and CuffSure groups, cuff pressures were measured and adjusted to safe levels using the respective device. Insertion attempts, ease of LMA placement, peak airway pressures, delivered tidal volumes, leak occurrence, hemodynamic parameters, and post-operative complications (sore throat, agitation, dysphagia, etc.) were recorded. Statistical analysis was done with ANOVA, Tukey?s post-hoc, and chi-square/Fisher?s exact tests (significance p<0.05). Results: Cuff pressure control was significantly improved with both devices compared to the volume-based method. The CuffSure group maintained the lowest mean intracuff pressures (~40 cmH?O), versus ~55 cmH?O with AG Cuffill and ~65 cmH?O in controls (p<0.001). Consequently, the CuffSure group had the lowest incidence of LMA leak (6% vs 10% in AG vs 15% control) and post-operative sore throat (10% vs 20% vs 30% control). CuffSure also yielded higher delivered tidal volumes and required fewer airway interventions (only 2% needed intubation vs 8% in controls, p=0.01). Peak inspiratory pressures were significantly lower in both device groups, reflecting better airway seals. Heart rate and blood pressure remained more stable in the CuffSure group, whereas controls showed higher intra-operative HR and BP (p=0.001). Other cuff-related complications like agitation, dysphagia, and dyspnoea were also lowest with CuffSure (all p<0.05). Conclusion: CuffSure was the most effective device for LMA cuff pressure management in children, achieving optimal cuff pressures with minimal leak and complications. Both devices outperformed the traditional volume-based technique, underscoring that routine intracuff pressure monitoring should be adopted in paediatric anaesthesia to improve airway safety and patient outcomes.

Keywords: Laryngeal mask airway, Cuff pressure, Paediatric anaesthesia, CuffSure, AG Cuffill, Airway complications, Manometry

How to Cite?: Dr. Apurva Agarwal, Dr. Pushpendra Kumar Saini, Dr. Veena Arora, Dr. Chandra Shekhar Singh, Dr. Neha Mishra, "Comparison of Efficacy of LMA Cuff Pressure Measurement: AG Cuffill vs CuffSure in Paediatric Population under General Anaesthesia", Volume 14 Issue 7, July 2025, International Journal of Science and Research (IJSR), Pages: 1735-1740, https://www.ijsr.net/getabstract.php?paperid=SR25728144048, DOI: https://dx.doi.org/10.21275/SR25728144048