i-gel® from Intersurgical: clinical evidence listing

Sood S, Saxena A, Thakur A, Chahar S. Saudi J Anaesth. 2019 Oct-Dec; 13(4): 290–294.

This prospective randomised study aimed to compare the performance of two supraglottic airway devices (SADs) the i-gel and LMA Fastrach when performing fiberoptic-guided intubation in adult paralysed patients. 60 patients were randomly assigned to either i-gel or LMA Fastrach. Several parameters were assessed, which included ease and time taken for fiberoptic-guided intubation (primary outcome), time taken for successful SAD placement, ease of insertion, ease and time of removal, as well as haemodynamic parameters and postoperative complication (secondary outcomes). Findings demonstrated that the Fastrach had a faster tracheal intubation and higher airway sealing pressure. On the other hand, the ETT was easier to insert when using the i-gel as compared to the Fastrach. Haemodynamic parameters were comparable between both devices. In addition, post removal complications were observed in either devices. Therefore, both devices are comparable in terms of performance and efficacy facilitating fiberoptic-guided intubation in adult paralysed patients.

Link to abstract.

Choudhary N, Kumar A, Kohli A, Wadhawan S, Bhadoria P. Indian J Anaesth. 2019 Mar;63(3):218-224

This investigation aimed to compare the successful intubation rate of the i-gel using three types of endotracheal tubes (ETTs). 75 ASA I and II patients (age 18-60 years) undergoing elective surgery under general anaesthesia were randomly assigned into three groups based on the type of endotracheal ETT, which included polyvinyl chloride ETT (Group P), intubating laryngeal mask airway ETT (Group I) and flexometallic ETT (Group F). Recorded parameters included time taken for successful intubation, success rate, number of attemps, manoeuvres, and complications. Results demonstrated that Group P had the lowest time and mean time for intubation, as well as the highest first attempt and overall intubation success rate. Therefore, the combination of polyvinyl chloride ETT with i-gel to intubate patients with difficult airways represents the most successful approach compared to other combinations. However, additional studies are needed to validate these results.

Link to abstract.

Lopez NT, McCoy SK, Carroll C, Jones E, Miller JA. Mil Med. 2018 Jun 19 [Epub ahead of print]

Prospective crossover study on cadavers to measure airway exchange on three pre-placed supraglottic airways: King LT, i-gel and LMA Unique. Participants, recruited from emergency medical personnel in a training lab, rated the difficulty level of placement of each airway device. Successful exchange equalled proper placement of the ETT in the trachea. Authors conclude the i-gel superior for blind airway exchange with an ETT in this set up.

Link to abstract.

Brandling J, Rhys M, Thomas M, Voss S, Davies S, Benger J. Scand J Trauma Resusc Emerg Med. 2016; 24: 56

A study within a UK ambulance study exploring the customs and beliefs or paramedics in relation to airway management and whether tracheal intubation sustains professional identity. Interviews were conducted with 17 participants, which identified four key factors: pride, utility, expectations and professionalisation. Authors conclude the interviews identified a 'wide range of views' on airway management based on evidence and experience.

Link to abstract

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.

Abstract text