i-gel® from Intersurgical: clinical evidence listing

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

Use of an i-gel® for airway rescue

Joshi NA, Baird M, Cook TM. Anaesthesia 2008; 63(9): 1010-1026

A middle-aged female patient was scheduled for an elective operation on her hand. She had undergone several general anaesthetics in the past when a cLMA had been used without documented problems. She had a Mallampati score of three and a thyromental distance of 6cm. Face mask ventilation with an oropharyngeal airway was extremely difficult. A pLMA was inserted, but ventilation was not possible. A size four cLMA was also tried with the same result. A size four i-gel® was then inserted. This immediately provided unobstructed ventilation and stable oxygenation saturation of 98%. The authors commented that ‘the i-gel®’s role in difficult airway management remains to be established, but its ease of insertion, short wide airway tube and good airway leak pressures make it a potentially useful airway device in cases of difficult mask ventilation.’

Link to abstract.

Extraglottic airway devices for use in diving medicine - part 3: the i-gel®

Acott CJ. Diving and Hyperbaric Medicine 2008; 38(3): 124-127

This study looked at the use of i-gel® in airway management of a patient in a diving bell or deck decompression chamber. The study highlighted the potential limitations of some supraglottic airways used in Hyperbaric Medicine, such as possible cuff expansion with a decrease in pressure on decompression and change in cuff volume due to gas diffusion as the gas mixtures change, problems not associated with i-gel®. It showed that, subjectively, there was no change in the consistency of the i-gel® at 203 and 283kPa pressure and that no bubbles were detected following decompression from 203, 283 or 608kPa. The i-gel® was also preferred by the Diver Medical Technicians (DMTs) to the alternative device included in the manikin section of the study because it ‘lacked a cuff and was easier to insert from any position’.

Link to abstract.

 

i-gel® insertion by novices in manikins and patients

Wharton NM, Gibbison B, Gabbott DA, Haslam GM, Muchatuta N, Cook TM. Anaesthesia 2008; 63(9): 991-995

This study evaluated the performance of i-gel® in manikins and anaesthetised patients when used by novices. The i-gel® was deployed with minimal evidence of patient trauma and 100% insertion success. In their summary, the authors concluded that, ‘i-gel® is rapidly inserted in both manikins and patients by novice users and compares favourably to other supraglottic airways available. Further work determining safety and efficacy during cardio-pulmonary resuscitation is required.’

Link to abstract.

 

Use of the i-gel® laryngeal mask for management of a difficult airway

Emmerich M, Dummler R. Anaesthesist 2008; 57(8): 779-781

In this case report, the i-gel® was used as a conduit for intubation in a patient who was known to have problems with intubation. Direct laryngoscopy was not possible, but ventilation and a good fibreoptic view of the glottis were achieved by using the i-gel®. Intubation via the device was completed successfully using a 6.0mm cuffed endotracheal tube.

Link to abstract.

Aspiration recognition with an i-gel® airway

Liew G, John B, Ahmed S. Anaesthesia 2008; 63(7): 786

A report on a case of a young male patient undergoing surgery where i-gel® helped with the recognition and management of regurgitation. During this case, gastric contents were noticed to be coming out of the gastric channel. No secretions were evident in the airway channel. As regurgitation continued, surgery was paused and the patient’s airway secured following rapid sequence induction. There was no clinical evidence of aspiration and a post-op chest X-ray revealed clear lung fields. It transpired the patient had consumed a fizzy drink a few hours prior to the operation, something he failed to mention during a pre-operative visit.

Link to abstract.