Kim YH. Korean J Anesthesiol 2012; 63(6): 489-490
Review assessing the use of SGAs in patients with increased risk of aspiration, focusing on five devices and the evidence to date. Provides a review of the common features of SGAs, including i-gel®, and the benefits they may bring. Author appears critical of the practice of using these devices, however later states that pulmonary aspiration may occur more through user error rather than device failure.
Russo SG, Cremer S, Eich C, Jipp M, Cohnen J, Strack M, Quintel M & Mohr A. BR J Anaesth 2012; 109(6): 996-1004
This randomized cross-over study of 12 volunteer patients was conducted primarily to measure the in situ position of the LMA Supreme® and i-gel® via MRI scan. Position was also assessed functionally and optically by fibrescope. Results showed that the devices differed significantly: the LMA Supreme® protruded deeper into the oesophageal sphincter, whilst i-gel® caused greater compression of the tongue. Glottic aperture reduction and hyoid bone displacement were also measured. Authors deem the results relevent to the risk of aspiration, glottic narrowing, airway resistance and soft-tissue morbidity.
Link to abstract.
Jeon WJ, Cho SY, Baek SJ, Kim KH. Korean J Anesthesiol. 2012; 63(6): 510-4
Adult patients undergoing gynaecological laparoscopy were split into two groups of 30 and randomly assigned to either PLMA or i-gel®. Insertion time and number of attempts were recorded. After successful insertion in all patients in both groups, on first attempt, airway leak pressure was also measured. No significant difference in insertion time or leak pressure. Authors conclude that i-gel® is a reasonable alternative to PLMA in this scenario.
Theiler L, Gutzmann M, Kleine-Brueggeney M, Urwyler N, Kaempfen B, Greif R. Br J Anaesth 2012; 109(6): 990-995
Over a period of 24 months, 2049 uses of the i-gel® were measured across five independent hospitals in Switzerland to evaluate insertion success rates, leak pressures, adverse events, and risk factors for failure. Patients’ mean age was 47 years. The authors concluded that the i-gel® is a reliable device, failing in less than 5% of patients and providing high leak pressures. Serious adverse events are rare.