i-gel® from Intersurgical: clinical evidence listing

Ye Q, Wu D, Fang W, Wong GTC, Lu Y.  BMC Anesthesiol. 2020;20(1):136. Published 2020 Jun 3.

This randomised observational study set out to evaluate and compare the antral cross-sectional area (CSA) in patients undergoing laparoscopic gynaecological surgery when managed with different supraglottic airway devices (SAD). One hundred ASA I and II female patients were assessed for the study enrolment and subsequently randomly allocated into three groups of different ventilation devices, which included LMA-Supreme (Group S), I-gel (Group I) or tracheal tube (Group T). Several parameters were measured including antral cross-sectional area (primary outcome), haemodynamic parameters and postoperative morbidity such as sore throat, hoarseness, dry throat, nausea and vomiting (secondary outcomes). Findings have demonstrated that the antral CSA was not significantly different among three groups before induction after induction and at the end of surgery. On the other hand, the haemodynamic variables were significantly higher in the tracheal tube group than in the LMA-Supreme and I-gel groups after insertion and after removal. Interestingly, sore throat was detected in none in the I-gel group compare to two patients in the LMA-Supreme group and fifteen patients in the tracheal tube group. Moreover, hoarseness was detected in one in the I-gel group, whereas two patients in the LMA-Supreme group and eleven patients in the tracheal tube group suffered from this postoperative adverse event.

Conclusions: The SADs do not cause obvious gastric insufflation. Thus, LMA-Supreme and I-gel can be widely used as alternative to endotracheal intubation for the short laparoscopic gynaecological surgery.

Link to abstract

Panneer M, Babu S, Murugaiyan P. Anesth Essays Res. 2017 Oct-Dec; 11(4): 930–933 
 
The objective of this study was to compare the hemodynamic disturbances and possible complications caused by the i-gel and ETT in 80 patients (ASA II) undergoing cesarean receiving general anesthesia. A range of parameters was investigated including insertion time, ease of intubation, hemodynamics (insertion and removal) and postoperative complications (sore throat, blood on device, dysphagia, regurgitation, nausea, vomiting, laryngospasm and aspiration). Findings have demonstrated that patients in the ETT group had a higher incidence of difficult intubation, 20% higher mean arterial pressure and heart rate compared to the i-gel group. The ETT group also had a higher incidence of sore throat. Thus, the i-gel constitutes a superior alternative to the ETT in patients undergoing elective surgery under general anaesthesia.

Link to abstract.

Liu ZJ, Yi J, Chen WY, Zhang XH, Huang YG. Medicine (Baltimore). 2017 May;96(19):e6905.

46 doctors with no intubation experience were given 20 minutes of airway training and a short practice session with the i-gel and Aura-I. They were then asked to insert each device into a manikin in random order and to attempt intubation through each airway. Time to ventilation, first-attempt and overall intubation success, incidence of gastric inflation, ease of insertion, view of the vocal cords, and insertion score were all recorded and compared. Participants attempted the same tasks at a 3-month follow-up session. First-attempt and overall success rates for intubation were high and comparable, with only 1 patient failing to intubate via the Aura-I at follow-up. Performance of the devices was generally comparable. Time to intubation was shorter with the i-gel at both time points. Participants also reported that the i-gel was easier to use. These results may be due to the lack of inflatable cuff.

Link to abstract

Kim JG, Kim W, Kang GH, Jang YS, Choi HY, Kim H, Kim M. Clin Exp Emerg Med. 2018 Mar 30;5(1):29-34. 

This prospective randomised crossover study was carried out to evaluate the performance and efficacy of the i-gel blind intubation (IGI) in airway management for pre-hospital trauma patients. Here, two blind intubation techniques were assessed (by 18 paramedics) using two supraglottic airway devices (IGI and LMA Fastrach) and a Macintosh laryngoscope (MCL).

Link to abstract.

Alzahem AM, Aqil M, Alzahrani TA, Aljazaeri AH. Saudi Med J. 2017 May;38(5):482-490

Randomised assignment of 112 patients to either AuraOnce or i-gel groups in which oropharyngeal leak pressure, ease of insertion and fibreoptic viewing were measured. i-gel recorded more favourable leak pressures and superior fibreoptic viewing.

Link to abstract.