i-gel® from Intersurgical: clinical evidence listing

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

Use of an i-gel® for airway rescue

Joshi NA, Baird M, Cook TM. Anaesthesia 2008; 63(9): 1010-1026

A middle-aged female patient was scheduled for an elective operation on her hand. She had undergone several general anaesthetics in the past when a cLMA had been used without documented problems. She had a Mallampati score of three and a thyromental distance of 6cm. Face mask ventilation with an oropharyngeal airway was extremely difficult. A pLMA was inserted, but ventilation was not possible. A size four cLMA was also tried with the same result. A size four i-gel® was then inserted. This immediately provided unobstructed ventilation and stable oxygenation saturation of 98%. The authors commented that ‘the i-gel®’s role in difficult airway management remains to be established, but its ease of insertion, short wide airway tube and good airway leak pressures make it a potentially useful airway device in cases of difficult mask ventilation.’

Link to abstract.

Aspiration recognition with an i-gel® airway

Liew G, John B, Ahmed S. Anaesthesia 2008; 63(7): 786

A report on a case of a young male patient undergoing surgery where i-gel® helped with the recognition and management of regurgitation. During this case, gastric contents were noticed to be coming out of the gastric channel. No secretions were evident in the airway channel. As regurgitation continued, surgery was paused and the patient’s airway secured following rapid sequence induction. There was no clinical evidence of aspiration and a post-op chest X-ray revealed clear lung fields. It transpired the patient had consumed a fizzy drink a few hours prior to the operation, something he failed to mention during a pre-operative visit.

Link to abstract.

Nerve damage following the use of an i-gel® supraglottic airway device

Theron AD, Loyden C. Anaesthesia 2008; 63(4): 441-442

This article describes a post-operative complication after i-gel® use. The patient was successfully ventilated with a size four i-gel®, which was in line with the recommendation for the patient’s weight (85kg). After surgery, the patient reported numbness in the lower lip. An examination shows swelling and an ulcer on the inside of the lip. There are two possible explanations for this injury – the patient’s lip may have been caught in the tape used to secure the i-gel® or it may have been caught in between the i-gel® and the patient’s teeth. The authors warn that this could occur with any airway device, but that extra care should be taken with the i-gel® due to the bulkier design.

Link to abstract.

Evaluation of four airway training manikins as patient simulators for the insertion of eight types of supraglottic airway devices

Jackson KM, Cook TM. Anaesthesia. 2007 Apr;62(4):388-93

The airway arm of this trial compared devices including i-gel, Cobra, SLIPA and Laryngeal Tube Suction II. Each device was inserted twice into each manikin by ten anaesthetists, with each insertion scored and ranked. No one manikin outranked the others for all devices. i-gel insertion was 'significantly the easiest'.

Link to abstract

The i-gel® airway for ventilation and rescue ventilation

Sharma S, Rogers R, Popat M. Anaesthesia 2007; 62(4): 412-423

This case report concerns use of an i-gel® on a teenage patient scheduled for closure of colostomy. Two years previously he had a grade 3 (Cormack & Lehane) view at laryngoscopy. On this occasion there were no clinical features to predict difficult intubation.Laryngoscopy revealed a grade 4 view. Two attempts at tracheal intubation with a gum elastic bougie failed. A cLMA® was inserted. Despite providing satisfactory ventilation, two attempts at fibreoptic intubation through the device failed. A size 4 i-gel® was inserted and satisfactory ventilation achieved. After fibreoptic confirmation of a good view of the vocal cords, a size 6.5mm cuffed tracheal tube was successfully passed through the i-gel® blindly into the trachea at the first attempt. The i-gel® was left in place until extubation.

Link to abstract.