i-gel® from Intersurgical: clinical evidence listing

A comprehensive list of all known published clinical evidence on the device

A comparison of the i-gel® supraglottic airway as a conduit for tracheal intubation with the intubating laryngeal mask airway: a manikin study

Michalek P, Donaldson W, Graham C, Hinds JD. Resuscitation 2010; 81(1): 74-77

In this study 25 anaesthetists carried out blind and fibreoptic intubations through the ILMA® and i-gel® devices. The study took place with three different airway training manikins. There was no difference in the success rate of fibreoptic intubations between the two airways. During blind intubation, the i-gel® was significantly less successful. The i-gel® is therefore recommended for fibreoptic intubation only.

Link to abstract.

A Comparison of Successful Eschmann Introducer Placement Through Four Supraglottic Airway Devices

Mitchell CA, Riddle ML, Pearson NM, Tauferner DH, Carl R. Annals Of Emergency Medicine 2010;5(3):S25

Study to determine if a bougie could be successfully placed in a cadaver by emergency medicine providers using four supraglottic airway devices: LMA Supreme®, i-gel®, LMA® and KingLT®. Time to placement, confidence in the procedure and correct placement via direct laryngoscopy post-removal were recorded. No great significant differences in most areas, however i-gel® was much quicker than KingLT® to successfully insert, and generally outperformed it. LMA Supreme® and i-gel® considered the better devices for such a procedure, although the authors concede that using a cadaver did inhibit the study.

Abstract link

 

Airway management for out-of-hospital cardiac arrest - more data required

Nolan JP, Lockey D. Resuscitation 2009; 80(12): 1333-1334

This editorial discusses the options that are available for airway management when cardiac arrest occurs outside a hospital environment. It is stated that supraglottic airways are easier to insert than endotracheal tubes and have the added benefit of allowing chest compressions to continue while they are inserted. The article references i-gel® studies with both positive and negative outcomes. Overall, insertion time was quicker but ventilation was sometimes found to be inadequate. One study showed that the i-gel® had a higher leak pressure than the cLMA, however a German study found that the i-gel® produced a tight seal at 20cm H2O in only around half of the patients involved. Most of the available i-gel® data comes from small studies. Randomised controlled trials are needed to confirm the performance of the i-gel® and other supraglottic airways during CPR.

Link to abstract.

 

Randomised crossover comparison between the i-gel® and the LMA Unique® in anaesthetised, paralysed adults

Uppal V, Gangaiah S, Fletcher G, Kinsella J. Br J Anaesth 2009; 103(6): 882-885

In this study, the i-gel® and LMA Unique® were both used in 39 patients. Leak pressure, insertion attempts, number of airway manipulations and leak volumes were similar for both devices. Insertion time was significantly less for the i-gel® at 12.2s compared to 15.2s for the LMA Unique®. It can be concluded that the i-gel® is a reasonable alternative to the LMA Unique® during controlled ventilation.

Link to abstract.

 

 

Supreme! Or is it?

Kushakovsky V, Ahmad I. Anaesthesia 2009; 64(11): 1262

This letter is a response to a small LMA Supreme® study. The authors say that they have been using the device in patients having nasopharyngeal surgery as it protects the airway from any bleeding and has a gastric channel to remove any blood in the stomach. However, they have reviewed recent research and believe that their current practice may change. In previous studies, the i-gel® has performed as well as the LMA Supreme® even when all i-gel® patients have been given a size 4 device and the LMA Supreme® has been sized correctly. Gastric tube placement in the two devices and the LMA Proseal® is also comparable. The authors are considering the use of the i-gel® or ProSealTM instead of the SupremeTM.

Link to abstract.