i-gel® from Intersurgical: clinical evidence listing

Nolan J. Resuscitation 2008; 76(1): 1-2

From the abstract: ‘Tracheal intubation has long been regarded as a fundamental and essential component of advanced life support (ALS). It has been assumed that tracheal intubation improves the chances of surviving from cardiac arrest. There are no reliable data to support this belief and there are several reasons why attempted intubation can be harmful, particularly when undertaken by inexperienced individuals.’

Abstract text

Dinsmore J, Maxwell W, Ickeringill M. J Resuscitation 2007; 5(4): 574-575

In the study described in this letter, 39 anaesthetists completed ease of use surveys for 227 i-gel® devices. Compared with their experience of the cLMA®, the anaesthetists considered the i-gel® quick and easy to insert. Insertion and ventilation on the first attempt were successful in the majority of cases. There were 18 unsatisfactory airways, six of which were caused by incorrect sizing. The i-gel® was comparable to the cLMA® in terms of adverse effects such as visible blood and sore throat.

Link to abstract.

Soar J. Resuscitation 2007; 74(1): 197

This case report detailed use of a size four i-gel® during a cardiac arrest. The i-gel® was inserted in <10 seconds from opening the packet. The author was able to ventilate the patient’s lungs easily using a self-inflating bag-valve device connected to the i-gel®. The patient’s lungs were ventilated asynchronously during chest compressions with no leak. There was no evidence of aspiration. In addition, this case report confirmed the training of five non-anaesthetic trainee doctors to insert the i-gel® and ventilate an anaesthetised patient after minimal instruction. All these trainees rated i-gel® easier to insert than a laryngeal mask airway.

Link to abstract.

Jackson KM, Cook TM. Anaesthesia. 2007 Apr;62(4):388-93

The airway arm of this trial compared devices including i-gel, Cobra, SLIPA and Laryngeal Tube Suction II. Each device was inserted twice into each manikin by ten anaesthetists, with each insertion scored and ranked. No one manikin outranked the others for all devices. i-gel insertion was 'significantly the easiest'.

Link to abstract

Gabbott DA, Beringer R. Resuscitation 2007; 73(1): 161-162

A letter on initial findings following clinical use of i-gel® in 100 patients. In order to evaluate its potential use in a resuscitation setting, the investigators confined their use to a size four device. They used i-gel® on 100 patients undergoing elective surgery under general anaesthesia. The device was used in patients with a weight range of 40-100kg. In 98/100 cases, the i-gel® was adequately positioned on the first or second attempt. The mean and median leak on sustained pressure was 24cmH2O. Airway trauma, demonstrated by visible blood on the device on removal, was only detected on one occasion.There was one case of regurgitation. The gastric fluid was successfully vented through the oesophageal drainage port without any evidence of aspiration.

Link to abstract.