i-gel® from Intersurgical: clinical evidence listing

Saracoglu KT, Demir A, Pehlivan G, Saracoglu A, Eti Z. Anaesthesiol Intensive Ther. 2018 Sep 17

This prospective clinical trial assessed and compared the airway leak pressure and the fiberoptic view of the i-gel in both supine and lateral positions. Moreover, the impact of the i-gel insertion on haemodynamics was also monitored. 100 patients undergoing saturation biopsy were intubated with the i-gel in the supine position, which was subsequently changed to lateral position. Several measurements were taken after intubation and change of position, which included mean arterial pressure, heart rate, peripheral O2 saturation and end-tidal CO2. Furthermore, number of insertion attempts, insertion time, oropharyngeal leak pressure (OLP), and device placement were also recorded. The i-gel was successfully inserted in 88 patients on the first attempt and the insertion time was circa 8 seconds. Moreover, the OLP (27.45 mm Hg supine and 26.04 in lateral position) and fiberoptic view were comparable in both positions. Hence, the i-gel can be safely employed in both supine and lateral positions.

Link to abstract.

Dhanda A, Singh S, Bhalotra AR, Chavali S. Turk J Anaesthesiol Reanim. 2017 Oct;45(5):270-276

The adequacy of i-gel for pressure-controlled ventilation (PCV) in 60 patients undergoing elective surgery was assessed in this study. Patients were randomly assigned to the i-gel group or cuffed tracheal tube group. Several parameters were evaluated such as insertion time, number of attempts, ease of insertion and performance of the cardiovascular system. Furthermore, air leak, leak volume, leak fraction and pharyngolaryngeal (PL) morbidity were also assessed. Findings have shown that i-gel was easier to insert compared to the tracheal tube. Heart rate and mean arterial pressure were higher following tracheal tube but comparable between the two groups after few minutes. Moreover, the leak volume and leak fraction were comparable between the two groups at 15 cm H2O but significantly different at 20 and 25 cm H2O (higher in the i-gel group), and PL morbidity was significantly higher in the tracheal tube. Therefore, the i-gel represents a valuable alternative to the cuffed ETT if pressure is limited to 15 - 20 cm H2O.

Link to abstract.

Dingley J, Stephenson J, Allender V, Dawson S, Williams D. Anaesthesia. 2018 Jul;73(7):856-862

To investigate the hypothesis that i-gel cuff softening occurs during warming to body temperature, this study used a probe to measure cuff hardness and resilience on devices mounted in a monitored water bath to provide 105,864 data points at 11 temperatures. Authors conclude that hardness and resilience reduced with warming, but at levels that may not be encountered during clinical use.

Link to abstract.

Lopez NT, McCoy SK, Carroll C, Jones E, Miller JA. Mil Med. 2018 Jun 19 [Epub ahead of print]

Prospective crossover study on cadavers to measure airway exchange on three pre-placed supraglottic airways: King LT, i-gel and LMA Unique. Participants, recruited from emergency medical personnel in a training lab, rated the difficulty level of placement of each airway device. Successful exchange equalled proper placement of the ETT in the trachea. Authors conclude the i-gel superior for blind airway exchange with an ETT in this set up.

Link to abstract.

Jain RA, Parikh DA, Malde AD, Balasubramanium B. Indian J Anaesth. 2018 Apr;62(4):269-279

This survey was sent to over 16,000 members of the Indian Society of Anaesthesiologists and given to delegates at the Asian Society of Paediatric Anaesthesiologists conference 2017. Percentage, mean and standard deviation were calculated. Results showed i-gel was the most commonly used device (60%) and 75% of respondents had access to second-generation supraglottic airways.

Link to abstract.