i-gel® from Intersurgical: clinical evidence listing

Luthra A, Chauhan R, Jain A, Bhukal I, Mahajan S, Bala I. Anesth Essays Res. 2019 Oct-Dec;13(4):669-675

This prospective randomized observational study was carried out to evaluate the efficacy of the i-gel as compared to the ProSeal laryngeal mask airway (PLMA) in non-paralysed anaesthetised patients. 40 ASA I-II patients, between 18 and 65 years of age, undergoing elective surgery were randomly allocated to either the i-gel or the PLMA. Observed parameters included insertion time, ease of insertion, number of attempts, failed insertion, airway reaction during insertion, oropharyngeal leak pressure (OLP), and gastric insufflation. Additionally, fibreoptic view of the channels of the devices and ease of insertion of Ryle's tube through the gastric drain channel and complications were also assessed. Results showed that both devices had a similar performance in terms of first attempt, overall insertion success rates and insertion times. On the other hand, the Ryle's tube passage was easier through the i-gel. Full view of the vocal cords was achieved in 17 patients intubated using the i-gel and 9 using the PLMA. In addition, the incidence and severity of postoperative sore throat and hoarseness was higher in the PLMA group. Thus, the i-gel provides superior approach in this type of patient as it is able to achieve a better positioning over the laryngeal framework and oesophagus while allowing an easier passage of the Ryle's tube through its drain channel as compared to the PLMA.

Link to abstract.

Pournajafian A, Alimian M, Rokhtabnak F, Ghodraty M, Mojri M. Anesth Pain Med. 2015 Mar 30;5(2):e22068.

61 patients were randomised for cLMA or I-gel insertion for brief orthopaedic surgery. Insertion time, success/failure rate, and incidence of complications (sore throat, hoarseness, bleeding) were all recorded. The devices were comparable, with a low incidence of complications overall and no instances of blood in the airway or on the device. The I-gel is therefore an acceptable alternative to the LMA Classic.

Link to abstract.

Lee YC, Yoon KS, Park SY, Choi SR, Chung CJ. Korean J Anesthesiol. 2018 Feb;71(1):37-42. 

In this study the performance of the i-gel and the LMA Supreme was evaluated in infants (ASA I and II) undergoing general anaesthesia. 60 patients were randomly assigned to the i-gel and the LMAS and the size of the devices was selected in accordance to the infant’s weight. A range of parameters including oropharyngeal leak pressure (primary outcome), fiberoptic view, airway quality, airway manipulations, insertion success rate and time (secondary outcomes) were investigated to determine the efficacy and safety of the two devices. Insertion time was shorter for the i-gel group.

Link to abstract.

An J, Nam SB, Lee JS, Lee J, Yoo H, Lee HM, Kim MS. Medicine (Baltimore). 2017 Jan;96(1):e5801

Authors conducted a specialised search of study databases for eligible randomised controlled trials, setting device insertion time and first-attempt insertion success rate as their primary outcomes. In the 14 RCTs included, i-gel was faster than the majority of other supraglottic airways, with only three others recording shorter insertion times. Authors concluded that the 'unapparent advantage' of insertion success rate indicated the need for further evidence gathering in this area.

Link to abstract.

Michálek P, Donaldson W, McAleavey F, Abraham A, Mathers RJ, Telford C. Prague Med Rep. 2016;117(4):164-175

Comparative study of three supraglottic airways as conduits in patients with predicted difficult laryngoscopy. Primary outcome measure was success rate of tracheal intubation through the device. No statistical difference was recorded in success rates between devices, however i-gel proved quicker to insert compared to ILMA and the intubation time was shorter compared to CTrach. i-gel is a suitable alternative to sILMA and CTrach in this scenario, and the shorter times recorded may provide an advantage in cases of difficult oxygenation.

Link to abstract.