i-gel® from Intersurgical: clinical evidence listing

Sood S, Saxena A, Thakur A, Chahar S. Saudi J Anaesth. 2019 Oct-Dec; 13(4): 290–294.

This prospective randomised study aimed to compare the performance of two supraglottic airway devices (SADs) the i-gel and LMA Fastrach when performing fiberoptic-guided intubation in adult paralysed patients. 60 patients were randomly assigned to either i-gel or LMA Fastrach. Several parameters were assessed, which included ease and time taken for fiberoptic-guided intubation (primary outcome), time taken for successful SAD placement, ease of insertion, ease and time of removal, as well as haemodynamic parameters and postoperative complication (secondary outcomes). Findings demonstrated that the Fastrach had a faster tracheal intubation and higher airway sealing pressure. On the other hand, the ETT was easier to insert when using the i-gel as compared to the Fastrach. Haemodynamic parameters were comparable between both devices. In addition, post removal complications were observed in either devices. Therefore, both devices are comparable in terms of performance and efficacy facilitating fiberoptic-guided intubation in adult paralysed patients.

Link to abstract.

Kohli M, Wadhawan S, Bhadoria P, Ratan SK. J Anaesthesiol Clin Pharmacol. 2019 Jan-Mar;35(1):30-35

This study aimed to determine the efficacy of the i-gel as compared to the ETT in terms of adequacy of ventilation in 80 children (2-8 years of age) undergoing paediatric laparoscopic surgeries. Several parameters were evaluated including peak airway pressure, end-tidal CO2, minute ventilation, SpO2, as well as desufflation of the peritoneal cavity. These variables were recorded after securing the airway, after carboperitoneum (CP) and after desufflation of the peritoneal cavity. Results showed a significant increase in the partial pressure of mean expired CO2 (PeCo2), peak airway pressure, as well as minute ventilation in both groups after creation of CP. On the other hand, no difference was observed in heart rate or mean arterial pressure. Moreover, the i-gel showed a smaller increase in peak airway pressure and fewer post-operative complications. Thus, both devices were comparable in terms of adequacy of ventilation, but the i-gel was able to provide a safe alternative to the ETT.

Link to abstract.

Bielski A, Smereka J, Madziala M, Golik D, Szarpak L. Eur J Pediatr. 2019 Jun;178(6):871-882

This manikin study aimed to compare the performance of several supraglottic airway devices (SADs) in different blind intubation scenarios performed by 116 inexperienced physicians. The devices used included i-gel, Air-Q laryngeal airway and Ambu AuraGain. The three devices were tested on a paediatric manikin in three different scenarios, which included normal airway without chest compressions (A), normal airway with continuous chest compressions plus the CORPLUS CPR system (CCS) (B), and difficult airway with continuous chest compressions plus CCS (C). Parameters assessed in this investigation included first intubation success rate, median time to SAD placement, time to endotracheal intubation, as well as ease of intubation. Results have shown that the i-gel performed better in every scenario and in all parameters tested as compared to the other devices. Therefore, these data demonstrated that the i-gel is the most effective device for emergency blind intubation performed by inexperienced physicians in paediatric patients.

Link to abstract.

Tracy MB, Priyadarshi A, Goel D, Lowe K, Huvanandana J, Hinder M. Arch Dis Child Fetal Neonatal Ed. 2018 May;103(3)

This manikin study assessed and compared the delivered ventilation of seven, size 1 LMA devices with two different face masks using self-inflating bags (SIBs). 40 participants carried out resuscitation on a specialised infant training manikin using the LMAs and the face masks in a random fashion. Findings have shown that the i-gel had the highest peak inspiratory pressure and higher PEEP compared to the other devices. In addition, the i-gel showed no insertion failures and all users described it as easy to use. Thus, these results indicate that the i-gel may become the primary resuscitation device used for newborn resuscitation.

Link to abstract.

Szarpak Ł. Am J Emerg Med. 2017 Mar;35(3):509-510. Epub 2016 Nov 12.

This study set out to determine the efficacy of blind intubation by novice physicians using the i-gel and the Air-Q devices. Prior the study, a training session focused on anatomy, physiology and pathophysiology of the airways, as well as methods for airway control was provided to all participants. The novice physicians were randomly assigned to either the i-gel or the Air-Q. Several parameters were assessed including time to intubation (primary outcome), time to secure the airway, efficacy of blind intubation and difficulty of the procedure (measured in visual-analogue scale or VAS). Results showed that the time for airway management was 6.5 seconds for the i-gel and 11 seconds for the Air-Q. Time to intubation was significantly shorter when using the i-gel as compared to the Air-Q. Moreover, the effectiveness of intubation was 90% for the i-gel and 78% for the Air-Q. i-gel also had a lower VAS score, and the majority of the participants preferred it to the Air-Q. Therefore, these results suggest that the i-gel represents a better choice for blind intubation by novice physicians when performing CPR.

Link to abstract.