All patients would undergo a pre-anesthetic evaluation comprising of history, general physical and systemic examinations. All efforts will be focused on the identification of any comorbid diseases and their optimization before surgery. Preoperative investigations would be appropriately performed to guide and optimize perioperative management. All patients shall be kept fasting for at least 6 hours.
Patients will be allocated to two groups of 25 patients each by random computer draw.
Group A - Securing airway with I-gel supraglottic airway device.
Group B - Securing airway with endotracheal tube (ETT).
All patients will be administered general anesthesia for the procedure. A Drager Fabius Plus Anesthesia Machine will be used in all cases with a co-axial closed circuit breathing system. A standardized protocol for induction and maintenance of anesthesia will be followed which would comprise of intravenous fentanyl (1-2mcg/kg) followed by propofol (1.5-2mg/kg) for induction. Airway will be secured by an appropriate size oral ETT or I-gel following administration of a non-depolarizing muscle relaxant. The head end of the patient will be covered with drapes to facilitate blinding of the investigator. Anesthesia will be maintained with desflurane in oxygen and nitrous oxide titrated to maintain FiO₂ of 0.5 at all times. A non-depolarizing muscle relaxant will be administered for maintenance of neuromuscular blockade during the surgical procedure. Standard volume control ventilation settings will be used in both groups with tidal volume of 8ml/kg, to maintain minute ventilation of 100ml/kg and end-tidal carbon dioxide (EtCO₂) between 30-40 mm Hg.
Initially high fresh gas flows (FGF) of 6 l/min will be used to achieve desired expired concentration of anesthetic gases and then FGF reduced to 1000 ml/min. The time of initiation of a FGF of 1000ml/min will be considered as Time 0. FGF will then be reduced by 100 ml/min till the final goal of 400 ml/min total FGF is achieved, which will be recorded as a state of no clinical leak in the breathing system. The FGF will not be reduced below the above limit. The FGF will not be reduced in case of collapse of bellows, ventilation alarms or desaturation. An independent observer, unaware of the airway device used, will record all observations. The parameters will be monitored and recorded every minute along with reduction of flows till 400 ml/min and thereafter every 15 min till 2 hours after which the study will be terminated. The following parameters will be recorded:

1. Heart rate
2. Blood pressure
3. Oxygen saturation
4. End tidal Carbon dioxide
5. Peak Airway pressure
6. Loss of tidal volume (Set tidal volume - Delivered tidal volume)
7. Total Flow delivered
8. Changes in above parameters with change in position from supine to Trendelenberg or reverse Trendelenberg.

Efficiency of placing naso/oro-gastric tube will be noted along with gastric distension at the beginning and end of surgery. At the end of the procedure, neuromuscular blockade will be reversed and post extubation patient will be shifted to PACU for observation.
Patients will be followed up in PACU and 24 hours after surgery in wards to note complaints of sore throat (constant pain, independent of swallowing, dysphagia, pain with swallowing), sore jaw, dysphonia, numbness of tongue or oropharynx, blocked or painful ears, reduced hearing or neck pain.

Statistical Power: The power of the study was calculated based on the study by Uppal et al¹ comparing I-gel with ETT using pressure controlled ventilation. To estimate the sample size a mean difference of 0.25 was considered to get clinically significant results between the two groups. The standard deviation value used was 0.05. Using a power of 80% and a significance value of 0.05 for a two-sample t-test comparing two groups a total of 24 patients per group would be needed.