i-gel® from Intersurgical: clinical evidence listing

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.

Saracoglu KT, Demir A, Pehlivan G, Saracoglu A, Eti Z. Anaesthesiol Intensive Ther. 2018 Sep 17

This prospective clinical trial assessed and compared the airway leak pressure and the fiberoptic view of the i-gel in both supine and lateral positions. Moreover, the impact of the i-gel insertion on haemodynamics was also monitored. 100 patients undergoing saturation biopsy were intubated with the i-gel in the supine position, which was subsequently changed to lateral position. Several measurements were taken after intubation and change of position, which included mean arterial pressure, heart rate, peripheral O2 saturation and end-tidal CO2. Furthermore, number of insertion attempts, insertion time, oropharyngeal leak pressure (OLP), and device placement were also recorded. The i-gel was successfully inserted in 88 patients on the first attempt and the insertion time was circa 8 seconds. Moreover, the OLP (27.45 mm Hg supine and 26.04 in lateral position) and fiberoptic view were comparable in both positions. Hence, the i-gel can be safely employed in both supine and lateral positions.

Link to abstract.

Dhanda A, Singh S, Bhalotra AR, Chavali S. Turk J Anaesthesiol Reanim. 2017 Oct;45(5):270-276

The adequacy of i-gel for pressure-controlled ventilation (PCV) in 60 patients undergoing elective surgery was assessed in this study. Patients were randomly assigned to the i-gel group or cuffed tracheal tube group. Several parameters were evaluated such as insertion time, number of attempts, ease of insertion and performance of the cardiovascular system. Furthermore, air leak, leak volume, leak fraction and pharyngolaryngeal (PL) morbidity were also assessed. Findings have shown that i-gel was easier to insert compared to the tracheal tube. Heart rate and mean arterial pressure were higher following tracheal tube but comparable between the two groups after few minutes. Moreover, the leak volume and leak fraction were comparable between the two groups at 15 cm H2O but significantly different at 20 and 25 cm H2O (higher in the i-gel group), and PL morbidity was significantly higher in the tracheal tube. Therefore, the i-gel represents a valuable alternative to the cuffed ETT if pressure is limited to 15 - 20 cm H2O.

Link to abstract.

Jain RA, Parikh DA, Malde AD, Balasubramanium B. Indian J Anaesth. 2018 Apr;62(4):269-279

This survey was sent to over 16,000 members of the Indian Society of Anaesthesiologists and given to delegates at the Asian Society of Paediatric Anaesthesiologists conference 2017. Percentage, mean and standard deviation were calculated. Results showed i-gel was the most commonly used device (60%) and 75% of respondents had access to second-generation supraglottic airways.

Link to abstract.