Luthra A, Chauhan R, Jain A, Bhukal I, Mahajan S, Bala I. Anesth Essays Res. 2019 Oct-Dec;13(4):669-675
This prospective randomized observational study was carried out to evaluate the efficacy of the i-gel as compared to the ProSeal laryngeal mask airway (PLMA) in non-paralysed anaesthetised patients. 40 ASA I-II patients, between 18 and 65 years of age, undergoing elective surgery were randomly allocated to either the i-gel or the PLMA. Observed parameters included insertion time, ease of insertion, number of attempts, failed insertion, airway reaction during insertion, oropharyngeal leak pressure (OLP), and gastric insufflation. Additionally, fibreoptic view of the channels of the devices and ease of insertion of Ryle's tube through the gastric drain channel and complications were also assessed. Results showed that both devices had a similar performance in terms of first attempt, overall insertion success rates and insertion times. On the other hand, the Ryle's tube passage was easier through the i-gel. Full view of the vocal cords was achieved in 17 patients intubated using the i-gel and 9 using the PLMA. In addition, the incidence and severity of postoperative sore throat and hoarseness was higher in the PLMA group. Thus, the i-gel provides superior approach in this type of patient as it is able to achieve a better positioning over the laryngeal framework and oesophagus while allowing an easier passage of the Ryle's tube through its drain channel as compared to the PLMA.
Link to abstract.
Amer GF, Abdeldayem OT, Lahloub FMF. Anesth Essays Res 2019 Apr-Jun; 13(2): 209-213
This investigation assessed the use of the i-gel as an alternative to local anaesthesia (LA) in insulin dependents diabetic patients undergoing cataract surgery. 60 diabetic patients were randomly assigned to receive either LA or general anaesthesia (n = 30) in combination with the i-gel (n = 30). Several parameters were monitored including mean arterial blood pressure (MBP), heart rate (HR), as well as blood glucose levels and plasma cortisol levels. Results have shown no significant difference in either blood glucose or cortisol levels in both groups. However, blood glucose level increased in both groups after induction of anaesthesia. In addition, HR and MBP increased in the LA group but not in the i-gel group. In conclusion, these results show that both LA and general anaesthesia using the i-gel are safe and do not produce a marked impact in hemodynamics, blood glucose, or cortisol levels in diabetic patients.
Link to abstract.
Choudhary N, Kumar A, Kohli A, Wadhawan S, Bhadoria P. Indian J Anaesth. 2019 Mar;63(3):218-224
This investigation aimed to compare the successful intubation rate of the i-gel using three types of endotracheal tubes (ETTs). 75 ASA I and II patients (age 18-60 years) undergoing elective surgery under general anaesthesia were randomly assigned into three groups based on the type of endotracheal ETT, which included polyvinyl chloride ETT (Group P), intubating laryngeal mask airway ETT (Group I) and flexometallic ETT (Group F). Recorded parameters included time taken for successful intubation, success rate, number of attemps, manoeuvres, and complications. Results demonstrated that Group P had the lowest time and mean time for intubation, as well as the highest first attempt and overall intubation success rate. Therefore, the combination of polyvinyl chloride ETT with i-gel to intubate patients with difficult airways represents the most successful approach compared to other combinations. However, additional studies are needed to validate these results.
Link to abstract.
Prabha R, Raman R, Parvez Khan M, Kaushal D, Siddiqui A, and
Abbas H. Saudi J Anaesth. 2018 Oct-Dec; 12(4): 535–539
This prospective controlled study aimed to examine the clinical performance of the i-gel in both obese and non-obese patients. 32 patients were divided into two groups, group O (BMI >30 kg/m2) and group C (BMI between 18.5 and 29.9 kg/m2). A range of parameters were evaluated including OLP (primary outcome), leak fraction, time taken to insert the device, ease of insertion, fiberoptic glottis view and adverse events. Results have demonstrated that OLP was marginally higher in Group O in comparison to group C (but not statistically different). In regards to the other parameters and side effects, these were comparable in both groups. Therefore, the i-gel provides an effective tool for the airway management of both obese and non-obese patients.
Link to abstract
Panneer M, Babu S, Murugaiyan P. Anesth Essays Res. 2017 Oct-Dec; 11(4): 930–933
The objective of this study was to compare the hemodynamic disturbances and possible complications caused by the i-gel and ETT in 80 patients (ASA II) undergoing cesarean receiving general anesthesia. A range of parameters was investigated including insertion time, ease of intubation, hemodynamics (insertion and removal) and postoperative complications (sore throat, blood on device, dysphagia, regurgitation, nausea, vomiting, laryngospasm and aspiration). Findings have demonstrated that patients in the ETT group had a higher incidence of difficult intubation, 20% higher mean arterial pressure and heart rate compared to the i-gel group. The ETT group also had a higher incidence of sore throat. Thus, the i-gel constitutes a superior alternative to the ETT in patients undergoing elective surgery under general anaesthesia.
Link to abstract.