i-gel® from Intersurgical: clinical evidence listing

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

Supreme laryngeal mask airway vs the I-gel supraglottic airway in patients under general anesthesia and mechanical ventilation with no neuromuscular block: a randomized clinical trial

Fernández Díez A, Prez Villafane A, Bermejo González JC, Marcos Vidal JM. Rev Esp Anestesiol Reanim 2009; 56: 474- 478

In this study, 85 patients were randomised into two groups for ventilation via LMA Supreme® or i-gel® supraglottic airways. Ease of insertion, seal pressure, ventilatory parameters and insertion of a gastric tube were all recorded. Both devices were easy to insert, with the SupremeTM and i-gel® being inserted on the first attempt in 95.2 and 86% of cases respectively. Performance was generally comparable.

Abstract text

 

A comparison of the i-gel® with the LMA-Unique® in non-paralysed anaesthetised adult patients

Francksen H, Renner J, Hanss R, Scholz J, Doerges V, Bein B. Anaesthesia 2009; 64(10): 1118-1124

In this study, 80 patients were randomly allocated to either i-gel® or LMA-Unique® insertion before minor surgery. Ventilation, insertion time, airway pressure, leak pressure and postoperative sore throat were all measured. Results were similar for all parameters other than airway leak pressure, which was significantly higher in the i-gel® (mean pressure 29cm H2O compared to 18cm H2O). Both devices are acceptable for use in securing an airway, however the increased leak pressure is an advantage for the i-gel®.

Link to abstract.

 

i-gel® and lightening of anaesthesia?

Ghai A, Saini S, Hooda S. Anaesthesia 2009; 64(10): 1151

This letter is a response to Baxter’s 2008 report of lightened anaesthesia due to a leak from the gastric channel of the i-gel®. The authors found that they experienced similar problems with the LMA Supreme®. No glottic structures were visualised on fibreoscopy through the airway channel, and through the gastric channel, it revealed the tip in front of the glottis rather than the oesophagus.

Link to abstract.

Supreme! Or is it? A reply

Cook TM, Gatward JJ. Anaesthesia 2009; 64(11): 1262-1263

This letter is a response to Kushakovsky and Ahmad (2009 - see above) regarding the performance of the LMA Supreme®, LMA ProSealTM and i-gel® devices. The letter states that the i-gel® and ProSeal® have both been shown to vent gastric contents when they have good placement and oesophageal seal, but that this has not been studied in the LMA Supreme®. Only small studies comparing the LMA Supreme®, ProSeal and i-gel® are available, although these generally show comparable performance. The authors recommend further research with larger study populations.

Link to abstract.

Tongue trauma associated with the i-gel® supraglottic airway

Michalek P, Donaldson WJ, Hinds JD. Anaesthesia 2009; 64(6): 692-693

This article includes three cases of patient injury caused by the i-gel®. In the first case, a paramedic had difficulty inserting the device. It was removed immediately and it was found that the patient was bleeding from the frenulum. The second patient’s tongue was caught in the bowl of the i-gel® during insertion. Although the i-gel® was repositioned successfully, there was minor swelling and bleeding upon removal. This patient reported soreness for three days. The final case involved an insertion which appeared successful, however the patient reported a sore tongue and loss of taste lasting three weeks. The authors recommend two alternative insertion techniques to avoid mouth injuries – sliding the i-gel® over the thumb into the mouth or rotating the device so the tongue cannot get caught.

Link to abstract.