i-gel® from Intersurgical: clinical evidence listing

Cook TM, El-Boghdadly K, McGuire B, McNarry AF, Patel A, Higgs A. Anaesthesia 2020 Jun; 75(6): 785-799

Severe acute respiratory syndrome‐corona virus‐2, which causes coronavirus disease 2019 (COVID‐19), is highly contagious. Airway management of patients with COVID‐19 is high risk to staff and patients. We aimed to develop principles for airway management of patients with COVID‐19 to encourage safe, accurate and swift performance. This consensus statement has been brought together at short notice to advise on airway management for patients with COVID‐19, drawing on published literature and immediately available information from clinicians and experts. Recommendations on the prevention of contamination of healthcare workers, the choice of staff involved in airway management, the training required and the selection of equipment are discussed. The fundamental principles of airway management in these settings are described for: emergency tracheal intubation; predicted or unexpected difficult tracheal intubation; cardiac arrest; anaesthetic care; and tracheal extubation. We provide figures to support clinicians in safe airway management of patients with COVID‐19. The advice in this document is designed to be adapted in line with local workplace policies.

Link to abstract

Amer GF, Abdeldayem OT, Lahloub FMF. Anesth Essays Res 2019 Apr-Jun; 13(2): 209-213

This investigation assessed the use of the i-gel as an alternative to local anaesthesia (LA) in insulin dependents diabetic patients undergoing cataract surgery. 60 diabetic patients were randomly assigned to receive either LA or general anaesthesia (n = 30) in combination with the i-gel (n = 30). Several parameters were monitored including mean arterial blood pressure (MBP), heart rate (HR), as well as blood glucose levels and plasma cortisol levels. Results have shown no significant difference in either blood glucose or cortisol levels in both groups. However, blood glucose level increased in both groups after induction of anaesthesia. In addition, HR and MBP increased in the LA group but not in the i-gel group. In conclusion, these results show that both LA and general anaesthesia using the i-gel are safe and do not produce a marked impact in hemodynamics, blood glucose, or cortisol levels in diabetic patients.

Link to abstract.

Panneer M, Babu S, Murugaiyan P. Anesth Essays Res. 2017 Oct-Dec; 11(4): 930–933 
 
The objective of this study was to compare the hemodynamic disturbances and possible complications caused by the i-gel and ETT in 80 patients (ASA II) undergoing cesarean receiving general anesthesia. A range of parameters was investigated including insertion time, ease of intubation, hemodynamics (insertion and removal) and postoperative complications (sore throat, blood on device, dysphagia, regurgitation, nausea, vomiting, laryngospasm and aspiration). Findings have demonstrated that patients in the ETT group had a higher incidence of difficult intubation, 20% higher mean arterial pressure and heart rate compared to the i-gel group. The ETT group also had a higher incidence of sore throat. Thus, the i-gel constitutes a superior alternative to the ETT in patients undergoing elective surgery under general anaesthesia.

Link to abstract.

Saracoglu KT, Demir A, Pehlivan G, Saracoglu A, Eti Z. Anaesthesiol Intensive Ther. 2018 Sep 17

This prospective clinical trial assessed and compared the airway leak pressure and the fiberoptic view of the i-gel in both supine and lateral positions. Moreover, the impact of the i-gel insertion on haemodynamics was also monitored. 100 patients undergoing saturation biopsy were intubated with the i-gel in the supine position, which was subsequently changed to lateral position. Several measurements were taken after intubation and change of position, which included mean arterial pressure, heart rate, peripheral O2 saturation and end-tidal CO2. Furthermore, number of insertion attempts, insertion time, oropharyngeal leak pressure (OLP), and device placement were also recorded. The i-gel was successfully inserted in 88 patients on the first attempt and the insertion time was circa 8 seconds. Moreover, the OLP (27.45 mm Hg supine and 26.04 in lateral position) and fiberoptic view were comparable in both positions. Hence, the i-gel can be safely employed in both supine and lateral positions.

Link to abstract.

Jain RA, Parikh DA, Malde AD, Balasubramanium B. Indian J Anaesth. 2018 Apr;62(4):269-279

This survey was sent to over 16,000 members of the Indian Society of Anaesthesiologists and given to delegates at the Asian Society of Paediatric Anaesthesiologists conference 2017. Percentage, mean and standard deviation were calculated. Results showed i-gel was the most commonly used device (60%) and 75% of respondents had access to second-generation supraglottic airways.

Link to abstract.