i-gel® from Intersurgical: clinical evidence listing

Russo SG, Cremer S, Galli T, Eich C, Bräuer A, Crozier TA, Bauer M, Strack M. BMC Anesthesiol 2012; 12: 18

Three groups of 40 elective patients each were assigned to i-gel®, LMA Supreme® and Laryngeal Tube Suction-D for a prospective, randomised and comparative study of position (fibre optic) and clinical performance data during surgery. Speed of insertion and success rates, leak pressure, dynamic airway compliance, and signs of postoperative airway morbidity were recorded, with i-gel® registering a 95% insertion success rate and the highest airway compliance. In conclusion, all devices were considered suitable for ventilation in elective surgery.

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Singh J, Yadav MK, Marahatta SB, Shrestha BL. Indian J Anaesth 2012; 56(4): 348-52

Prospective, crossover, randomised trial of i-gel® against cLMA on 48 post-burn neck contracture patients with reduced neck movement and mouth opening. Primary outcome was overall success rate, with other measurements taken in time to ventilation, leak pressure, fibreoptic view and visualisation of square wave pattern. Success rate for i-gel® was 91.7%, against 79.2% for cLMA. i-gel® outperformed cLMA in all measurements. Authors conclude their study has ‘better clinical performance in the difficult airway management of the airway in the post burn contracture of the neck’.

Link to abstract.

Siddiqui AS, Ahmed J, Siddiqui SZ, Haider S, Raza SA. J Coll Physicians Surg Pak. 2012; 22(7): 419-23

An experimental study using i-gel® on 100 female patients undergoing elective gynaecologic surgery was performance-measured on ease of insertion, time to insert, peak airway pressure and leak pressure. A gastric tube was placed in each patient. Pharyngolaryngeal morbidities were also recorded. In 92% of patients, i-gel® was inserted successfully first time and there were no instances of blood on the device post-procedure. Authors confirm the i-gel® is a simple and easy to use device.

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Larkin CB, d’Agapeyeff A, King BP, Gabbott DA. Resuscitation 2012; 83(6): E141

100 size 4 i-gel® airways were inserted in patients by a mixture of nurses, junior doctors and Resuscitation Officers, either before or after bag valve mask ventilation. 83/100 insertions were considered ‘Easy’ and 82/100 were inserted at the first attempt, with only one attempt resulting in complete failure. Presence of an audible leak and visible chest movement via synchronous and asynchronous ventilation were measured. 99% of users confirmed they would prefer to use i-gel® instead of an oropharyngeal airway. Authors confirm that, as a result of this test, i-gel® is their preferred supraglottic airway device of choice during the initial phase of CPR whilst the Resuscitation Team is summoned.

Link to abstract.

Taxak S, Bhardwaj M, Gopinath A. J Anaesth Clin Pharmacol 2012; 28(2): 263–264

Two successful cases of paediatric i-gel® used to manage the airway during brain MRI under general anaesthesia. The first, a three-month-old, was maintained using size one; whilst a size two was used on the second case, a boy aged three-and-a-half with a Mallampati score of two. Usual capnography readings taken to ensure secure placement, and in both cases there was no evidence of desaturation. Compared to other laryngeal mask airways, the authors conclude that i-gel® suffers no risk of displacement, meaning intubation does not have to be repeated on known sensitive patients. They also deduce that i-gel® has other advantages, including ease of insertion and minimum adverse effects on removal of the device. Large studies are required, however, to ‘confirm its usefulness’.

Link to abstract.