Ye Q, Wu D, Fang W, Wong GTC, Lu Y. BMC Anesthesiol. 2020;20(1):136. Published 2020 Jun 3.
This randomised observational study set out to evaluate and compare the antral cross-sectional area (CSA) in patients undergoing laparoscopic gynaecological surgery when managed with different supraglottic airway devices (SAD). One hundred ASA I and II female patients were assessed for the study enrolment and subsequently randomly allocated into three groups of different ventilation devices, which included LMA-Supreme (Group S), I-gel (Group I) or tracheal tube (Group T). Several parameters were measured including antral cross-sectional area (primary outcome), haemodynamic parameters and postoperative morbidity such as sore throat, hoarseness, dry throat, nausea and vomiting (secondary outcomes). Findings have demonstrated that the antral CSA was not significantly different among three groups before induction after induction and at the end of surgery. On the other hand, the haemodynamic variables were significantly higher in the tracheal tube group than in the LMA-Supreme and I-gel groups after insertion and after removal. Interestingly, sore throat was detected in none in the I-gel group compare to two patients in the LMA-Supreme group and fifteen patients in the tracheal tube group. Moreover, hoarseness was detected in one in the I-gel group, whereas two patients in the LMA-Supreme group and eleven patients in the tracheal tube group suffered from this postoperative adverse event.
Conclusions: The SADs do not cause obvious gastric insufflation. Thus, LMA-Supreme and I-gel can be widely used as alternative to endotracheal intubation for the short laparoscopic gynaecological surgery.
Link to abstract
Mishra SK, Sivaraman B, Balachander H, Naggapa M, Parida S, Bhat RR, Yuvaraj K. Anesth Essays Res. 2015 Sep-Dec;9(3):353-8
60 patients were enrolled to either i-gel or ProSeal groups, with the primary objective to compare sealing pressure. Authors conclude ProSeal gave a better seal.
Link to abstract
Mukadder S, Zekine B, Erdogan KG, Ulku O, Muharrem U, Saim Y, Mahmut D. ScientificWorldJournal. 2015;2015:634320
105 patients were randomly distributed between the three device groups. Initial leak pressure, insertion time, ease of placement and airway morbidity results all favoured the i-gel.
Link to abstract
Jeon WJ, Cho SY, Baek SJ, Kim KH. Korean J Anesthesiol. 2012; 63(6): 510-4
Adult patients undergoing gynaecological laparoscopy were split into two groups of 30 and randomly assigned to either PLMA or i-gel®. Insertion time and number of attempts were recorded. After successful insertion in all patients in both groups, on first attempt, airway leak pressure was also measured. No significant difference in insertion time or leak pressure. Authors conclude that i-gel® is a reasonable alternative to PLMA in this scenario.
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.