i-gel® from Intersurgical: clinical evidence listing

Taxak S, Gopinath A, Saini S, Bansal T, Ahlawat MS, Bala M. Saudi J Anaesth. 2015 Oct-Dec;9(4):446-50

40 patients were allocated to either the i-gel or ProSeal group. Insertion of i-gel on first attempt was successful in 17 of 20 patients, compared to 16 for ProSeal, and was faster to insert. Authors conclude ProSeal provided the better seal but insertion was easier with i-gel.

Link to abstract

Taxak S, Bhardwaj M, Gopinath A. J Anaesth Clin Pharmacol 2012; 28(2): 263–264

Two successful cases of paediatric i-gel® used to manage the airway during brain MRI under general anaesthesia. The first, a three-month-old, was maintained using size one; whilst a size two was used on the second case, a boy aged three-and-a-half with a Mallampati score of two. Usual capnography readings taken to ensure secure placement, and in both cases there was no evidence of desaturation. Compared to other laryngeal mask airways, the authors conclude that i-gel® suffers no risk of displacement, meaning intubation does not have to be repeated on known sensitive patients. They also deduce that i-gel® has other advantages, including ease of insertion and minimum adverse effects on removal of the device. Large studies are required, however, to ‘confirm its usefulness’.

Link to abstract.

Taxak S, Gopinath A. Minerva Anestesiol 2010; 76(5): 381

This case study describes the use of the i-gel® while the patient was in a prone position for surgery. A 45kg 16-year-old boy laid in a prone position with his head turned laterally. After induction of anaesthesia, a size three i-gel® was inserted on the first attempt. There were no adverse events either during or after surgery and the i-gel® was removed while the patient was still prone. Previous research has shown that the cLMA and ProSealTM airways can be inserted in the prone position, and i-gel®s have successfully ventilated prone patients who were turned over after insertion. However, this is the first reported case of i-gel® insertion while the patient is already prone. Routine use of this technique should only occur after further research has taken place.

Abstract text

Taxak S, Gopinath A. Anaesthesiology 2010; 112(2): 500-501

This correspondence article responds to Theiler et al’s comments on the design of the i-gel® and subsequent effects of tongue size. The authors state that they have noticed a similar issue where the patient’s tongue is carried towards the back of the mouth by the i-gel®, which then cannot be inserted fully. The i-gel® had to be removed and re-inserted. The authors recommend stabilising the tongue before attempting to insert the device. A reply from the authors of the original report says that a tongue retractor should be used for this rather than fingers. This response also points out that although the tongue may also get caught between the teeth and the i-gel® bite block, this could happen with any supraglottic airway.

Link to abstract.