BackgroundThe pediatric-sized Streamlined Liner of Pharyngeal Airway (SLIPA) is a new supraglottic airway device for children. AimsThe aim of this study was to compare the clinical performance of the pediatric-sized SLIPA with the Laryngeal Mask Airway-Unique in paralyzed children under positive pressure-controlled ventilation (PCV). MethodsOne hundred children, aged 2 months to 12 years with American Society of Anesthesiologists physical status I-II were enrolled and randomly allocated to the SLIPA group or the Laryngeal Mask Airway-Unique group (50 patients in each group). The primary outcome variable was oropharyngeal leak pressure. Other outcome variables were first insertion success rate, insertion time, minor airway interventions required for successful insertion, intraoperative dislodgement, ventilatory data, and perioperative complications. ResultsThe insertion characteristics, ventilation data, and perioperative complications were comparable between the two groups. The leak pressure of the SLIPA was significantly higher than that of the Laryngeal Mask Airway-Unique [median (IQR): 25 (22-30) cmH(2)O vs 21 (19-26) cmH(2)O, respectively; mean sd: 25.3 +/- 4.6 cmH(2)O vs 22.6 +/- 4.8 cmH(2)O, respectively; P = 0.006]. The incidence of intraoperative dislodgment was significantly lower in the SLIPA group than in the Laryngeal Mask Airway-Unique group (0 vs 6 patients, respectively; P = 0.027). ConclusionsIn conclusion, both the SLIPA and the Laryngeal Mask Airway-Unique can be used effectively without severe complications in paralyzed children. Additionally, the SLIPA provides a better airway seal and better intraoperative position stability than the Laryngeal Mask Airway-Unique.