i-gel® from Intersurgical: clinical evidence listing

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

Case series: protection from aspiration and failure of protection from aspiration with the i-gel® airway

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.

Early experiences with the i-gel®

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.

Evaluation of four airway training manikins as patient simulators for the insertion of eight types of supraglottic airway devices

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

The i-gel® supraglottic airway: A potential role for resuscitation?

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.

The i-gel® airway for ventilation and rescue ventilation

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.