i-gel® from Intersurgical: clinical evidence listing

Michalek, P, Donaldson, W. Resuscitation 2010; 81(7): 911

This article is a response to Xue et al (2010). The authors generally agree that there are limitations to this study. However, the tracheal tubes used were noticeably longer than the body of the i-gel®. Although the results of manikin studies cannot be extrapolated to clinical practice, they are an important part of the testing needed before a product is used on patients.

Link to abstract.

Michalek P, Donaldson W, Graham C, Hinds JD. Resuscitation 2010; 81(1): 74-77

In this study 25 anaesthetists carried out blind and fibreoptic intubations through the ILMA® and i-gel® devices. The study took place with three different airway training manikins. There was no difference in the success rate of fibreoptic intubations between the two airways. During blind intubation, the i-gel® was significantly less successful. The i-gel® is therefore recommended for fibreoptic intubation only.

Link to abstract.

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.

Michalek P, Hodgkinson P, Donaldson W. Anesth Analg 2008; 106(5): 1501-1504

This case study describes successful fibreoptic guided tracheal intubation through the i-gel® in two uncooperative adult patients with learning disability and predicted difficult airway. The i-gel® maintained the airway immediately after induction, allowing oxygenation and ventilation. Fibreoptic identification of the laryngeal inlet was successful on the first attempt and a tracheal tube inserted into the trachea, without complication, in both patients.

Link to abstract.