i-gel® from Intersurgical: clinical evidence listing

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

Comparison of the i-gel® with the cuffed tracheal tube during pressure-controlled ventilation

Uppal V, Fletcher G, Kinsella J. Br J Anaesth 2009; 102(2): 264-8

In this study, published in the BJA, twenty-five patients were given a standard anaesthetic, followed by insertion of an i-gel. The lungs were ventilated at three different pressures and the difference between the inspired and expired tidal volumes used to calculate the leak volume and leak fraction. The i-gel was then removed and replaced with a conventional tracheal tube, for which similar readings were taken. The results were then compared. From the data taken, the authors concluded that, ‘compared with a tracheal tube there is no significant difference in the gas leak when using an i-gel during PCV with moderate airway pressures’.

Link to abstract.

 

 

Is i-gel® a new revolution among supraglottic airway devices? - a comparative evaluation

Jindal P, Rizvi A, Sharma JP. Middle East J Anesthesiol. 2009; 20(1): 53-58

This study compared i-gel® to two other supraglottic airways in respect of haemodynamic changes, including heart rate, systolic and diastolic blood pressure, mean arterial pressure and rate pressure product. The authors concluded that ‘i-gel® effectively conforms to the perilaryngeal anatomy despite the lack of an inflatable cuff, it consistently achieves proper positioning for supraglottic ventilation and causes fewer haemodynamic changes as compared to other supraglottic airway devices.’

Link to abstract.

 

A preliminary study of i-gel®: a new supraglottic airway device

Kannaujia A, Srivastava U, Saraswat N, Mishra A, Kumar A, Saxena S. Indian J Anaesth 2009; 53(1): 52-56

50 patients had the i-gel® inserted for ventilation during surgery. The number of insertion attempts, insertion time, manipulations required for an effective airway and seal pressure were recorded. Gastric tube placement and adverse events were also noted where they occurred. Before removal of the device, stability was tested by measuring the expiratory tidal volume with the patient’s head in standard, rotated, chin lift and no-pillow positions. Success rate was 90% at the first attempt and 100% at the second. Median insertion time was 11 seconds. Insertion depth was increased in four patients and a jaw thrust was required in two more. All gastric tubes were placed successfully. Mild cough or postoperative sore throat was seen in a total of four patients. Seal pressure was approximately 20cm H2O. The i-gel® was also found to be stable during head and neck movement.

Link to abstract.

 

Phenomenon with i-gel® airway: a reply

Chapman D. Anaesthesia 2009; 64(2): 228

This letter is a reply to Baxter (2008). Baxter described two incidents where air was ‘entrained through the suction port’ leading to decreased end-tidal sevoflurane and lightened anaesthesia. This response suggests that the devices in question may not have been inserted fully, meaning that the airway and gastric channels were not isolated from each other. To ensure full insertion takes place, users should make sure that the level of anaesthesia, patient position and insertion method are correct.

Abstract text

A comparison of correct i-gel® placement with and without the aid of a bougie

Gosalia N, Khan RM, Kaul N, Sumant A. J Anaesth Clin Pharmacol 2009; 25(3): 345-347

In this study, the i-gel®’s placement and performance were studied for insertions carried out with and without the use of a gum elastic bougie. 50 patients were randomised into two groups. In the first group, the i-gel® was inserted using the standard method. In the second group, a bougie was used to insert the device via the gastric channel. The time taken for insertion and the number of attempts needed were similar for both methods. Leakage and patient discomfort were less common when the bougie was used. The authors conclude that using a bougie improves i-gel® placement without increasing insertion time or adverse effects.

Link to abstract.