i-gel® from Intersurgical: clinical evidence listing

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

Kohli M, Wadhawan S, Bhadoria P, Ratan SK. J Anaesthesiol Clin Pharmacol. 2019 Jan-Mar;35(1):30-35

This study aimed to determine the efficacy of the i-gel as compared to the ETT in terms of adequacy of ventilation in 80 children (2-8 years of age) undergoing paediatric laparoscopic surgeries. Several parameters were evaluated including peak airway pressure, end-tidal CO2, minute ventilation, SpO2, as well as desufflation of the peritoneal cavity. These variables were recorded after securing the airway, after carboperitoneum (CP) and after desufflation of the peritoneal cavity. Results showed a significant increase in the partial pressure of mean expired CO2 (PeCo2), peak airway pressure, as well as minute ventilation in both groups after creation of CP. On the other hand, no difference was observed in heart rate or mean arterial pressure. Moreover, the i-gel showed a smaller increase in peak airway pressure and fewer post-operative complications. Thus, both devices were comparable in terms of adequacy of ventilation, but the i-gel was able to provide a safe alternative to the ETT.

Link to abstract.

Belena JM, Ochoa EJ, Nunez M, Gilsanz C, Vidal A. World J Gastrointest Surg. 2015;7(11):319-25

Literature search performed on laryngeal mask airway devices with drain tubes to determine efficacy of ventilation and protection against aspiration when compared with tracheal intubation. Results included studies on LMA Supreme, LMA Classic, LMA ProSeal and i-gel.

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Badheka JP, Jadliwala RM, Chhaya VA, Parmar VS, Vasani A, Rajyaguru AM. J Minim Access Surg. 2015 Oct-Dec;11(4):251-6

60 patients were randomly assigned to either the i-gel or ETT group. Ease, insertion attempts and insertion time were measured, followed by gastric tube insertion attempts and perioperative complications. i-gel was quicker to insert and is a safe and suitable alternative to ETT in this scenario.

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Park SY, Rim JC, Kim H, Lee JH, Chung CJ. Korean J Anesthesiol. 2015 Oct;68(5):455-61

93 patients were allocated into i-gel or LMA Supreme groups, with insertion time, attempts and fibreoptic view of glottis recorded. No significant differences were recorded.

Link to abstract