i-gel® from Intersurgical: clinical evidence listing

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.

Prabha R, Raman R, Parvez Khan M, Kaushal D, Siddiqui A, and
Abbas H. Saudi J Anaesth. 2018 Oct-Dec; 12(4): 535–539

This prospective controlled study aimed to examine the clinical performance of the i-gel in both obese and non-obese patients. 32 patients were divided into two groups, group O (BMI >30 kg/m2) and group C (BMI between 18.5 and 29.9 kg/m2). A range of parameters were evaluated including OLP (primary outcome), leak fraction, time taken to insert the device, ease of insertion, fiberoptic glottis view and adverse events. Results have demonstrated that OLP was marginally higher in Group O in comparison to group C (but not statistically different). In regards to the other parameters and side effects, these were comparable in both groups. Therefore, the i-gel provides an effective tool for the airway management of both obese and non-obese patients.

Link to abstract

Ahn E, Choi G, Kang H, Baek C, Jung Y, Woo Y, Bang S. PLoS One. 2018 Nov 5;13(11):e0206804

This network meta-analysis (with a mixed-treatment comparison method to combine direct and indirect comparisons) compared the effectiveness of seven different SADs as a strategy for unassisted tracheal intubation. The primary outcome was the overall success rate of intubation by intention to treat (ITT) and the secondary outcomes included the overall tracheal intubation success rate (per protocol - PP) and the success rate of tracheal intubation at first attempt by ITT and PP.

Link to abstract.

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.

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.