i-gel® from Intersurgical: clinical evidence listing

Gatward JJ, Thomas MJC, Nolan JP, Cook TM. Br J Anaesth 2008; 100(3): 351-356

In this study, 40 volunteer doctors regularly involved in CPR, were timed inserting four different airway devices, including i-gel® and a tracheal tube, with and without stopping chest compressions. Comparison of the speed of insertion of the different devices during CPR allowed ranking of the devices. The i-gel® was inserted approximately 50% faster than the other devices tested.

Link to abstract.

Michalek P, Hodgkinson P, Donaldson W. Anesth Analg 2008; 106(5): 1501-1504

This case study describes successful fibreoptic guided tracheal intubation through the i-gel® in two uncooperative adult patients with learning disability and predicted difficult airway. The i-gel® maintained the airway immediately after induction, allowing oxygenation and ventilation. Fibreoptic identification of the laryngeal inlet was successful on the first attempt and a tracheal tube inserted into the trachea, without complication, in both patients.

Link to abstract.

Theron AD, Loyden C. Anaesthesia 2008; 63(4): 441-442

This article describes a post-operative complication after i-gel® use. The patient was successfully ventilated with a size four i-gel®, which was in line with the recommendation for the patient’s weight (85kg). After surgery, the patient reported numbness in the lower lip. An examination shows swelling and an ulcer on the inside of the lip. There are two possible explanations for this injury – the patient’s lip may have been caught in the tape used to secure the i-gel® or it may have been caught in between the i-gel® and the patient’s teeth. The authors warn that this could occur with any airway device, but that extra care should be taken with the i-gel® due to the bulkier design.

Link to abstract.

Richez B, Saltel L, Banchereau F, Torrielli R, Cros AM. Anesth Analg. 2008; 106(4): 1137-9

This study on 71 ASA I-II women scheduled for gynaecological surgery, reported a 97% insertion success rate with i-gel®. Mean seal pressure was 30cm H2O. A gastric tube was inserted in 100% of cases. Only one case of coughing and sore throat occurred. The authors concluded that ‘the i-gel® is a reliable, easily inserted airway device that provides an adequate seal with a low morbidity rate.’

Link to abstract.

Gibbison B, Cook TM, Seller C. Br J Anaesth 2008; 100(3): 415-417

Regurgitation of gastric contents was seen in three low-risk patients during anaesthesia. In two patients where only low volumes of gastric fluid were seen flowing from the i-gel®, there was no sign of aspiration. An 85kg male patient regurgitated large amounts of liquid, and although this was mostly expelled from the i-gel®’s gastric channel there were signs of minor aspiration. The i-gel® allowed early identification of regurgitation in these cases.

Link to abstract.