Background/Objectives: Supraglottic airway devices are commonly used airway management tools, with various second-generation laryngeal masks available for patients undergoing general anesthesia. These devices offer improved sealing, gastric suction capabilities, and the potential for tracheal intubation. This study compared the recently introduced Singularity^TM Air laryngeal mask with two well-established devices, Ambu^® AuraGain^TM and i-GEL^®, under clinical conditions. Methods: We prospectively included 98 adult patients scheduled for elective surgery requiring general anesthesia. Patients were randomized to one of three laryngeal mask groups, and data on insertion success, ventilation efficiency, and postoperative complications, such as sore throat and dysesthesia, were collected. The primary endpoint was oropharyngeal sealing pressure, with additional assessments of insertion ease and bronchoscopic glottic visibility. Results: Median initial oropharyngeal leak pressure was lowest with i-GEL^® (22 cm H₂O) as opposed to Ambu^® AuraGain^TM (25 cm H₂O) and Singularity^TM Air (25 cm H₂O) [p = 0.0138], but this difference equalized after 15–30 min. I-GEL^® showed higher insertion success (88%, p = 0.001) and shorter time-to-first ventilation (29 s, p = 0.0106). Conversely, the gastric tube insertion rate was lower (70% versus >90% in the other masks). The Ambu^® AuraGain^TM and Singularity^TM Air performed similarly for most parameters. No significant differences were observed in tracheal intubation potential or postoperative adverse events among the three groups. Conclusions: The Singularity^TM Air performed comparably to Ambu^® AuraGain^TM and i-Gel laryngeal masks in oropharyngeal sealing pressure. I-Gel^® had the highest successful insertion rate. Most of the differences detected were not statistically significant, with all three masks providing effective 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.