i-gel® from Intersurgical: clinical evidence listing

Jeon WJ, Cho SY, Baek SJ, Kim KH. Korean J Anesthesiol. 2012; 63(6): 510-4

Adult patients undergoing gynaecological laparoscopy were split into two groups of 30 and randomly assigned to either PLMA or i-gel®. Insertion time and number of attempts were recorded. After successful insertion in all patients in both groups, on first attempt, airway leak pressure was also measured. No significant difference in insertion time or leak pressure. Authors conclude that i-gel® is a reasonable alternative to PLMA in this scenario. 

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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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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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Emmerich M, Tiesmeier J. Minerva Anestesiol 2012; 78(10): 1169-70

A 69-year-old man with a history of difficult intubation could not be intubated via conventional bronchoscopy. Different ETT sizes and airway manoeuvres were tried without success, until the bronchoscope was properly placed through a size 5 i-gel. Operation was completed without complication and the patient reported no neck discomfort or difficulty breathing.

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