Objective: Supraglottic airway devices (SGAs) have advantages in reducing respiration-associated complications. However, limited studies on the influence of head and neck rotation on the risk of air leakage have been conducted. We hypothesize that different head and neck rotation angles will increase the risk of air leakage when using SGAs. Methods: A prospective, randomized study was conducted with 51 patients in the i-gel^(TM) group and 50 patients in the AuraOnce^(TM) group. The head and neck were subsequently rotated to the following positions: 0 (neutral), 15, 30, 45, and 60 degrees. Airway pressure over 20 cmH_2O was defined as negative for air leakage. Results: The percentage of air leakage was proportional to the increase in rotational degrees at the various rotation angles. The incidence of patients without air leakage at the largest angle (60 degrees) of head and neck rotation in both groups was approximately 80% (i-gel^(TM): 82.35%; AuraOnce^(TM): 79.59%). Conclusion: SGAs presented acceptable performance with increased head and neck rotation angles.
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