i-gel® from Intersurgical: clinical evidence listing

Suhitharan T, Teoh WH. Saudi J Anaesth. 2013 Oct;7(4):436-41

Ransomised control trial comparing LMA Supreme with i-gel in 70 patients, with leak pressure, insertion success rates and leak fractions among the outcomes measured. While no post-operative complications were reported with i-gel, three patients suffered mild sore throat and one had mucosal injury in the Supreme group. i-gel had a higher but 'clinically inconsequential' leak fraction.

Link to abstract

Jagannathan N, Sommers K, Sohn LE, Sawardekar A, Shah RD, Mukherji II, Miller S, Voronov P, Seraphin S. Paediatr Anaesth.; 23(2): 127-33

Total of 170 children were assigned to either the i-gel® or LMA Supreme®, with leak pressure the primary outcome measured. Secondary evaluations included insertion time, insertion success rate, fibreoptic view and complications, to name a few. Resulting median leak pressure was higher with i-gel® and the authors conclude it could be a ‘useful alternative to the Supreme®’.

Link to abstract.

Russo SG, Cremer S, Eich C, Jipp M, Cohnen J, Strack M, Quintel M & Mohr A. BR J Anaesth 2012; 109(6): 996-1004

This randomized cross-over study of 12 volunteer patients was conducted primarily to measure the in situ position of the LMA Supreme® and i-gel® via MRI scan. Position was also assessed functionally and optically by fibrescope. Results showed that the devices differed significantly: the LMA Supreme® protruded deeper into the oesophageal sphincter, whilst i-gel® caused greater compression of the tongue. Glottic aperture reduction and hyoid bone displacement were also measured. Authors deem the results relevent to the risk of aspiration, glottic narrowing, airway resistance and soft-tissue morbidity.

Link to abstract.

Schmidbauer W, Genzwürker H, Ahlers O, Proquitte H, Kerner T. Br J Anaesth 2012; 109(3): 454-8

This, the first data collection study on the extent of oesophageal insufflation when oropharyngeal leak pressures are exceeded, used the i-gel® inserted into cadavers. Compared alongside LMA Supreme®, LMA ProSeal®, LTS-DTM, LTS IITM and Combitube®, performance was measured in a surgically-closed trachea to replicate total airway obstruction. Volume of insufflation from controlled ventilation was measured at inspirator pressures of 20, 40 and 60 mbar, with the former producing no insufflation with any device.

Abstract link

Russo SG, Cremer S, Galli T, Eich C, Bräuer A, Crozier TA, Bauer M, Strack M. BMC Anesthesiol 2012; 12: 18

Three groups of 40 elective patients each were assigned to i-gel®, LMA Supreme® and Laryngeal Tube Suction-D for a prospective, randomised and comparative study of position (fibre optic) and clinical performance data during surgery. Speed of insertion and success rates, leak pressure, dynamic airway compliance, and signs of postoperative airway morbidity were recorded, with i-gel® registering a 95% insertion success rate and the highest airway compliance. In conclusion, all devices were considered suitable for ventilation in elective surgery.

Abstract text