i-gel® from Intersurgical: clinical evidence listing

No HJ, Koo BW, Oh AY, Seo KS, Na HS, Ryu JH, Lee SW. Medicine (Baltimore) 2016 Jul;95(28):e4273.

Observational analysis of medical records of previous anaesthetic procedures at one university hospital. Comparison of the two anaesthetic agents included use of four supraglottic airways: LMA Flexible, LMA Supreme, LarySeal and i-gel.

Link to abstract

Aqil M, Delvi B, Abujamea A, Alzahrani T, Alzahem A, Mansoor S, Aaljazaeri A. Minerva Anestesiol. 2016 Jun 17

Sixty paediatric patients were split between the two groups, with scans of head and neck performed after confirmation of device placement. Both devices 'significantly' reduced the area of glottis opening. i-gel produced greater dilation of upper oesophogeal sphincter. Authors conclude more studies needed to test these results to 'reduce morbidity on pediatric airway'.

Link to abstract

Original post by Pearson K. Reply by Cook TM. Anaesthesia Correspondence Website. 2016. Accessed 22 May.

In the original post, and in response to Cook's study on abandoning vintage laryngeal masks (Br J Anaesth. 2015 Oct;115(4):497-9), Pearson cautions against the 'universal replacement of 1st generation devices' especially considering sub-group care (paediatrics), versatility, training and cost, and instead suggests there should not be a one-size-fits-all approach. Pearson also comments on the significant move towards the use of i-gel in her hospital.

In response to this, Cook suggests clinicians use the best performing and safest device where available as first choice. Cook makes mention of the two published meta-analyses on i-gel in children: by Choi GJ and Maitra S.

Link to abstract

Abukawa Y, Hiroki K, Iwakiri H, Fukuda T, Ozaki M. J Anesth. 2016;30(2):199-204

130 patients aged 7 months to 13 years monitored under general anaesthesia, with size selection based on patient's body weight. Average insertion length grew longer with increasing height and weight. Authors conclude a line could be drawn on sizes 1.5 and 2 only.

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Cuvas Apan O, Apan A. Rev Bras Anestesiol. 2016;66(2):171-5

270 patients aged 0-12 years not requiring tracheal intubation were recruited. After induction, thenar eminence dimensions were measured and compared with the patient's inserted i-gel. Authors conclude their results showed that the dimensions of thenar eminence fitted the weight-based size selection of i-gel, and that it could be a practical way to choose the correct size device.

Link to abstract