i-gel® from Intersurgical: clinical evidence listing

Acott CJ. Diving and Hyperbaric Medicine 2008; 38(3): 124-127

This study looked at the use of i-gel® in airway management of a patient in a diving bell or deck decompression chamber. The study highlighted the potential limitations of some supraglottic airways used in Hyperbaric Medicine, such as possible cuff expansion with a decrease in pressure on decompression and change in cuff volume due to gas diffusion as the gas mixtures change, problems not associated with i-gel®. It showed that, subjectively, there was no change in the consistency of the i-gel® at 203 and 283kPa pressure and that no bubbles were detected following decompression from 203, 283 or 608kPa. The i-gel® was also preferred by the Diver Medical Technicians (DMTs) to the alternative device included in the manikin section of the study because it ‘lacked a cuff and was easier to insert from any position’.

Link to abstract.

Mustafaeva MN, Mizikov VM, Kochneva ZV, Vashchinskaia TV, Sarkisova NG, Rusakov MA, Levitskaia NN. Anesteziol Reanimatol 2008; (5): 55-58

This paper describes the development of supraglottic airways and the i-gel® in particular. A review of the available i-gel® literature showed that there are considerable benefits to using the device during general anaesthesia. The experiences of the authors during the use of i-gel® in 34 patients are also described. The authors believe that the i-gel® is suitable for use during anaesthesia and potentially resuscitation. However, more research should be carried out, especially in terms of comparison with other supraglottic airways.

Link to abstract.

Emmerich M, Dummler R. Anaesthesist 2008; 57(8): 779-781

In this case report, the i-gel® was used as a conduit for intubation in a patient who was known to have problems with intubation. Direct laryngoscopy was not possible, but ventilation and a good fibreoptic view of the glottis were achieved by using the i-gel®. Intubation via the device was completed successfully using a 6.0mm cuffed endotracheal tube.

Link to abstract.

Liew G, John B, Ahmed S. Anaesthesia 2008; 63(7): 786

A report on a case of a young male patient undergoing surgery where i-gel® helped with the recognition and management of regurgitation. During this case, gastric contents were noticed to be coming out of the gastric channel. No secretions were evident in the airway channel. As regurgitation continued, surgery was paused and the patient’s airway secured following rapid sequence induction. There was no clinical evidence of aspiration and a post-op chest X-ray revealed clear lung fields. It transpired the patient had consumed a fizzy drink a few hours prior to the operation, something he failed to mention during a pre-operative visit.

Link to abstract.

Thompson J, O’Neill S. Br J Hosp Med 2008; 69(5): 303

This review article compares supraglottic airways to tracheal intubation for laparoscopic surgery. Evidence gathered so far indicates that supraglottic airways such as the i-gel® produce adequate ventilation and pressures with a reduced risk of complications such as aspiration. The authors state that further investigation should take place to determine whether these devices can be used in obese patients during laparoscopic procedures.

Link to abstract.