i-gel® from Intersurgical: clinical evidence listing

Dinsmore J, Maxwell W, Ickeringill M. J Resuscitation 2007; 5(4): 574-575

In the study described in this letter, 39 anaesthetists completed ease of use surveys for 227 i-gel® devices. Compared with their experience of the cLMA®, the anaesthetists considered the i-gel® quick and easy to insert. Insertion and ventilation on the first attempt were successful in the majority of cases. There were 18 unsatisfactory airways, six of which were caused by incorrect sizing. The i-gel® was comparable to the cLMA® in terms of adverse effects such as visible blood and sore throat.

Link to abstract.

Jackson KM, Cook TM. Anaesthesia. 2007 Apr;62(4):388-93

The airway arm of this trial compared devices including i-gel, Cobra, SLIPA and Laryngeal Tube Suction II. Each device was inserted twice into each manikin by ten anaesthetists, with each insertion scored and ranked. No one manikin outranked the others for all devices. i-gel insertion was 'significantly the easiest'.

Link to abstract

Gabbott DA, Beringer R. Resuscitation 2007; 73(1): 161-162

A letter on initial findings following clinical use of i-gel® in 100 patients. In order to evaluate its potential use in a resuscitation setting, the investigators confined their use to a size four device. They used i-gel® on 100 patients undergoing elective surgery under general anaesthesia. The device was used in patients with a weight range of 40-100kg. In 98/100 cases, the i-gel® was adequately positioned on the first or second attempt. The mean and median leak on sustained pressure was 24cmH2O. Airway trauma, demonstrated by visible blood on the device on removal, was only detected on one occasion.There was one case of regurgitation. The gastric fluid was successfully vented through the oesophageal drainage port without any evidence of aspiration.

Link to abstract.

Sharma S, Rogers R, Popat M. Anaesthesia 2007; 62(4): 412-423

This case report concerns use of an i-gel® on a teenage patient scheduled for closure of colostomy. Two years previously he had a grade 3 (Cormack & Lehane) view at laryngoscopy. On this occasion there were no clinical features to predict difficult intubation.Laryngoscopy revealed a grade 4 view. Two attempts at tracheal intubation with a gum elastic bougie failed. A cLMA® was inserted. Despite providing satisfactory ventilation, two attempts at fibreoptic intubation through the device failed. A size 4 i-gel® was inserted and satisfactory ventilation achieved. After fibreoptic confirmation of a good view of the vocal cords, a size 6.5mm cuffed tracheal tube was successfully passed through the i-gel® blindly into the trachea at the first attempt. The i-gel® was left in place until extubation.

Link to abstract.

Levitan RM, Kinkle WC. Anaesthesia 2005; 60(10): 1022- 1026

The first ever published study examined the positioning and mechanics of the i-gel® in 65 non-embalmed cadavers, with 73 endoscopies, 16 neck dissections and six neck radiographs. The mean percentage of glottic opening score for the 73 insertions was 82%. In each of the neck dissections and radiographs the bowl of the device covered the laryngeal inlet. In their summary, the authors concluded that the i-gel® was consistently positioned over the laryngeal inlet and that the unique gel-like material of the device performed as intended, conforming to the perilaryngeal anatomy.

Link to abstract.