In-vitro evaluation of the Singularity Air laryngeal mask: a randomized controlled comparison between medical personnel trained and untrained in airway management

INTRODUCTION: Supraglottic airway devices (SGAs) are essential tools in anesthesia and emergency medicine and are easier to teach than endotracheal intubation. The Singularity Air is a recently introduced second-generation laryngeal mask featuring an adjustable shaft angle to improve sealing. This study compared its bench performance between medical personnel with and without airway management training. MATERIAL AND METHODS: In this randomized, controlled in-vitro study, medical personnel each performed five consecutive insertions using the Singularity Air and a comparator device. Study Part A included 20 participants without anesthesia training, who used the LMA Unique. Study Part B included 20 anesthesia-trained staff, who used the Ambu AuraGain. The primary endpoint was time to successful ventilation, defined as visible chest movement of the mannequin. Participants rated insertion difficulty on a 0-10 scale. RESULTS: Overall insertion success was 99-100% across all devices. For the Singularity Air, median time to successful ventilation on the first attempt was 17 seconds (IQR 10-22) in the non-anesthesiology group and 12 seconds (IQR 10-14) in the anesthesia-trained group (P = 0.287). By the fifth attempt, both groups achieved 7.5 seconds (IQR 5-10 and 6-8, respectively; P = 0.674). Time to ventilation and difficulty ratings were low and comparable to the established devices. The non-anesthesiology participants improved more between the first and fifth attempts than anesthesia-trained participants (P = 0.152). CONCLUSIONS: The Singularity Air laryngeal mask achieved a high success rate and comparable time to ventilation in an in-vitro study when used by acute care medical personnel, regardless of prior airway management training. Larger clinical studies are warranted to confirm these findings and evaluate performance in real patients.