i-gel® from Intersurgical: clinical evidence listing

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.

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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.

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Gasteiger L, Brimacombe J, Oswald E, Perkhofer D, Tonin A, Keller C, Tiefenthaler W. Acta Anaesthesiol Scand 2012; 56(10): 1321-1324

Fifty-one children aged 1.5-6 years, weighing 10-25kg, were studied randomly using either the size 2 LMA ProSeal® or i-gel®. The hypothesis tested was that oropharyngeal leak pressure and fiberoptic position of the airway tube differ between the two devices, with results proving similar.

Link to abstract.

Nishiyama T, Kohno Y, Kim HJ, Shin WJ, Yang HS. The American Journal Of Emergency Medicine 2012; 30(9): 1756- 1759

180 patients were randomised into two equal groups, one for insertion of i-gel® at room temperature, the other at 37 degrees centigrade. Insertion time, number of insertion attempts, inspiratory and leak pressures, and leak fraction were compared. Report found no significant difference between the two groups.

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Salmen M, Ewy G, Sasson C. BMJ Open 2012; 3: 2(5)

Collating data from 12 observational studies on the topic, covering both guidelines, the aim was to investigate the effect of both methods of treatment on cardiac arrest patients. Authors concluded that there is an ‘association with improved survival’ when cardiocerebral (CCR) protocols or 2005 Guidelines are compared with older versions, and that CCR appears to be a ‘promising resuscitation protocol for Emergency Medical Services’.

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