i-gel® from Intersurgical: clinical evidence listing

Chapman D. Anaesthesia. 2017 Feb;72(2):263-264.

Response to the letter from Seeley et al. Manufacturer posits that the reason for light anaesthesia and hence air entrainment, may have been caused by the tip of the device not being located in the upper oesophageal opening and the non-inflatable cuff located against the laryngeal framework, meaning the airway and gastric channels would not be isolated from each other. In the event described by the case report, reference to the user guide would suggest reinsertion of the device using a gentle jaw thrust, deep rotation or triple maneouvre to achieve optimum depth of insertion.

Link to abstract.

Seeley JP, Pearson K, Baxter A. Anaesthesia. 2017 Feb;72(2):262-263.

Case report of light anaesthesia in a patient with a size 1.5 i-gel, despite adequate inspired concentration of sevoflurane and optimum positioning of the device by experienced operators. Entrainment was confirmed by capnography. No harm came to the patient. Authors pose the question of whether the gastric port inlet is positioned too anteriorly in paediatric i-gel sizes.

Link to abstract.

Lai CJ, Liu CM, Wu CY, Tsai FF, Tseng PH, Fan SZ. BMC Anesthesiol. 2017 Jan 6;17(1):3

Randomised controlled trial of 40 patients divided equally between i-gel and ETT groups. Leak fraction was the primary outcome, defined as leak volume divided by inspired tidal volume. In the LPT position, no difference was recorded in the leak fraction. In the i-gel group there was 'notably less' leakage in LPT position than in supine - this difference was not observed in the ETT group. Incidence of postoperative sore throat was significantly lower in the i-gel group.

Link to abstract.

Nirupa R, Gombar S, Ahuja V, Sharma P. Indian J Anaesth. 2016 Oct;60(10):726-731

Prospective, randomised controlled study on 100 patients, with the primary outcome being leak pressure assessed at five minutes. i-gel recorded 'superior' pressure and shorter insertion times compared to ProSeal.

Link to abstract

Liew GH, Yu ED, Shah SS, Kothandan H. Singapore Med J 2016; 57(8): 432-437

150 adult patients undergoing general anaesthesia were randomly assigned to 3 groups for ventilation via one of the SADs. Speed and ease of insertion, ease of gastric tube insertion, amount of gastric contents drained, leak pressure, and complications were all recorded. Patients were interviewed 1 and 24h after surgery to determine the incidence and severity of sore throat, hoarseness and dysphagia.

Link to abstract.