i-gel® from Intersurgical: clinical evidence listing

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

The influence of head and neck position on ventilation with the i-gel® airway in paralysed, anaesthetised patients

Sanuki T, Uda R, Sugioka S, Daigo E, Son H, Akatsuka M, Kotani J. Eur J Anaesthesiol. 2011 Aug;28(8):597-9

20 adult patients scheduled for oral surgery were ventilated using the i-gel®. Leak pressure, ventilation score and fibreoptic view were measured with the patient’s head and neck in neutral position, extended position, flexion and rotated to the right. Leak pressure was higher during flexion, lower during extension and comparable to neutral position during rotation. Ventilation score was significantly worse during flexion. Fibreoptic view was not affected by head and neck position. The authors recommend that the i-gel® is not used in cases where head and neck flexion is likely, but they state that it is otherwise suitable for surgery where the head is moved.

Link to abstract.

 

Successful use of i-gel in three patients with difficult intubation and difficult ventilation

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.’

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Failure to ventilate with supraglottic airways after drowning

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.

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Airway management in simulated restricted access to a patient--can manikin-based studies provide relevant data?

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’.

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i-gel® vs AuraOnceTM laryngeal mask for general anaesthesia with controlled ventilation in paralyzed patients

Donaldson W, Abraham A, Deighan M, Michalek P. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2011; 155(2): 155–164

Devices were generally comparable with high overall and first-attempt success rates. The i-gel® had a significantly higher seal pressure (30.4 compared to 27.8cm H2O) and a lower incidence of postoperative complications.

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