i-gel® from Intersurgical: clinical evidence listing

Jolliffe L, Jackson I. Curr Opin Anaesthesiol. 2008; 21(6): 719- 722

This review highlighted the potential benefits of the current supraglottic airway devices available and their suitability for ambulatory surgery. With regard to i-gel®, it was commented that it was designed to ‘anatomically fit the perilaryngeal and hypolaryngeal structures without the need for an inflatable cuff. This offers the potential for easier insertion, reduced tissue compression and increased stability after insertion.’ They further reported that, ‘Higher mean seal pressures help to facilitate ventilation in laparoscopic work’.

Link to abstract.

Baxter, S. Anaesthesia 2008; 63(11): 1265

This correspondence article reports a problem that occurred in two patients ventilated with an i-gel® during anaesthesia. In the first case, anaesthesia started to lighten and end-tidal sevoflurane fell. The user suspected air entrainment through the suction port. In the second case, anaesthesia remained stable but end-tidal sevoflurane still dropped. The user placed a finger over the suction port and sevoflurane levels returned to normal. In both cases, the i-gel® was replaced with a laryngeal mask airway.

Link to abstract.

Bamgbade OA, Macnab WR, Khalaf WM. Eur J Anaesthesiol 2008; 25(10): 865-6
This letter reported that first time insertion with i-gel® was achieved in <5 seconds in 290/300 patients. Three patients with difficult airway underwent successful fibreoptic endotracheal intubation through i-gel® and all patients underwent adequate pressure mode ventilation with airway pressures of 10-30cm H2O initially and spontaneous breathing subsequently. In addition, lubricated gastric tubes were easily inserted through the gastric channel at the first attempt in all 80 cases where this was performed. The authors concluded that ‘i-gel® is very suitable for peri-operative airway management, positive pressure ventilation and weaning from ventilation. It is also useful as an intubation aid and has a potential role in airway management during resuscitation. It is very easy to use, highly reliable and associated with minimal morbidity. The gastric channel separates the oesophagus from the larynx and provides protection from aspiration. Further studies are required to compare i-gel® with other supraglottic devices.’

Abstract text

Gatward JJ, Cook TM, Seller C, Handel J, Simpson T, Vanek V, Kelly F. Anaesthesia 2008; 63(10):1124-1130

A study of i-gel® in 100 elective, anaesthetised patients. Parameters assessed included ease of use, positioning, airway quality, seal pressure and complications. First time insertion success was 86%. Median airway leak pressure was 24cm H2O. On fibreoptic examination via the device, the vocal cords were visible in 91% of patients. The incidence of airway obstruction, airway irritation, oropharyngeal trauma and other complications was low. Insertion of the device into the correct position was rapid and easy. The authors concluded that, ‘these attributes would suggest potential roles in anaesthesia, management of the difficult airway and airway management during CPR’. Further studies are now indicated against i-gel®’s likely clinical competitors.

Link to abstract.

Bamgbade OA, Macnab WR, Khalaf WM. Eur J Anaesthesiol 2008; 25(10): 865-866

This letter reported that first time insertion with i-gel® was achieved in <5 seconds in 290/300 patients. Three patients with difficult airway underwent successful fibreoptic endotracheal intubation through i-gel® and all patients underwent adequate pressure mode ventilation with airway pressures of 10-30cm H2O initially and spontaneous breathing subsequently. In addition, lubricated gastric tubes were easily inserted through the gastric channel at the first attempt in all 80 cases where this was performed. The authors concluded that ‘i-gel® is very suitable for peri-operative airway management, positive pressure ventilation and weaning from ventilation. It is also useful as an intubation aid and has a potential role in airway management during resuscitation.'

Link to abstract.