i-gel® from Intersurgical: clinical evidence listing

Corso RM, Piraccini E, Agnoletti V, Baccanelli M, Coffa A, Gambale G. Minerva Anaestesiol 2011; 77(8): 852-3

The i-gel® was used in eight patients for tracheostomy. Patients were extubated and the ET tube was replaced with the i-gel®. A percutaneous tracheostomy kit was then advanced to the second tracheal ring and the procedure was performed. Arterial pressure, PaO2/FiO2, minute ventilation and airway pressure were measured before, during and after tracheostomy. There were no significant differences in ventilatory and haemodynamic parameters. Use of the i-gel® was successful in seven of eight patients. The i-gel® provided better views of the glottis compared to the cLMA and ventilation was comparable to the ET tube. Large trials must take place to determine whether a one in eight failure rate remains.

Abstract text

Baker P, Webber J. Anaesth Intensive Care 2011; 39(4): 675-7

Reported failure of an i-gel® and an Ambu® AuraOnceTM to ventilate a drowning victim due to changes in lung physiology following inhalation of water requiring ventilation pressures up to 40cmH20. Authors say that supraglottic airways, thanks to rapid insertion, are recommended for resuscitation as they facilitate the continuation of cardiac compression, however low leak pressures may cause inadequate ventilation and entrainment of air into the stomach of drowning victims.

Abstract text

Asai T. Masui. 2011; 60(7): 850-2

Three cases of successful ventilation using the size three i-gel® on female patients with a mix of predicted and unpredicted difficult intubation, and where both facemask ventilation and tracheal intubation were difficult. Author concludes that i-gel ‘has a potential role as a rescue device, by allowing ventilation and tracheal intubation in patients with difficult airways.’

Abstract text

Weber U, Oguz R, Potura LA, Kimberger O, Kober A, Tschernko E. Anaesthesia 2011; 66(6): 481-487

In this crossover study, 50 adult patients with BMI 25-35kg/m2 were assigned to ventilation with the i-gel® and the LMA Unique® in random order. Insertion attempts, difficulty (on a scale of 1-4), time to insertion and leak pressure were measured with each device. Leak pressure was higher with the i-gel®, with a mean value of 23.7cm H2O compared to 17.4cm H2O with the LMA Unique®. Within the study population, there was a bigger difference in leak pressures amongst patients with BMI >30. Insertion was generally comparable, although the i-gel® had a significantly shorter insertion time.

Abstract text

Nakstad AR, Sandberg M.Scand J Trauma Resusc Emerg Med. 2011 13; 19: 36

Twenty anaesthesiologists from the Air Ambulance Department at Oslo University Hospital used i-gel®, laryngeal tube LTSII™ and Macintosh laryngoscopes in two scenarios with either unrestricted (scenario A) or restricted (scenario B) access to the cranial end of the manikin. Technique selected, success rates and time to completion were primary outcomes. Results showed that in scenario B, all physicians secured the airway on first attempt, compared to 80% for ETI, whilst also completing in a quicker time. Authors conclude that ‘ETI was time consuming and had a low success rate’.

Abstract text