i-gel® from Intersurgical: clinical evidence listing

A comprehensive list of all known published clinical evidence on the device

Supreme! Or is it? A reply

Cook TM, Gatward JJ. Anaesthesia 2009; 64(11): 1262-1263

This letter is a response to Kushakovsky and Ahmad (2009 - see above) regarding the performance of the LMA Supreme®, LMA ProSealTM and i-gel® devices. The letter states that the i-gel® and ProSeal® have both been shown to vent gastric contents when they have good placement and oesophageal seal, but that this has not been studied in the LMA Supreme®. Only small studies comparing the LMA Supreme®, ProSeal and i-gel® are available, although these generally show comparable performance. The authors recommend further research with larger study populations.

Link to abstract.

Tongue trauma associated with the i-gel® supraglottic airway

Michalek P, Donaldson WJ, Hinds JD. Anaesthesia 2009; 64(6): 692-693

This article includes three cases of patient injury caused by the i-gel®. In the first case, a paramedic had difficulty inserting the device. It was removed immediately and it was found that the patient was bleeding from the frenulum. The second patient’s tongue was caught in the bowl of the i-gel® during insertion. Although the i-gel® was repositioned successfully, there was minor swelling and bleeding upon removal. This patient reported soreness for three days. The final case involved an insertion which appeared successful, however the patient reported a sore tongue and loss of taste lasting three weeks. The authors recommend two alternative insertion techniques to avoid mouth injuries – sliding the i-gel® over the thumb into the mouth or rotating the device so the tongue cannot get caught.

Link to abstract.

A randomised crossover trial comparing the i-gel® supraglottic airway and classic laryngeal mask airway

Janakiraman C, Chethan DB, Wilkes AR, Stacey MR, Goodwin, N. Anaesthesia 2009; 64(6): 674-678

This study compared the performance of i-gel® and cLMA airways in 50 healthy adult patients. The success rate on the first insertion attempt was significantly lower in the i-gel® group. Overall success after two attempts did not show a significant difference, although a change of device size was allowed. Leak pressures and fibreoptic view of the vocal cords were significantly better with the i-gel®, with the two devices producing leak pressures of 20 (i-gel®) and 17cm H2O (cLMA). 14 patients needed a change in i-gel® size.

Link to abstract.

 

Ventilation during resuscitation efforts for out-of-hospital primary cardiac arrest

Bobrow B J, Ewy G A. Curr Opin Crit Care 2009; 15(3): 228-33

A discussion on recent findings surrounding the role of ventilation during CPR during OHCA, focusing on whether passive oxygen insufflation is an optimal form of ventilation when compared to intubation and active assisted ventilation. The authors summarise and suggest that training prehospital medical providers to use passive insufflation may increase critical organ perfusion and therefore survival after OHCA.

Abstract text