i-gel® from Intersurgical: clinical evidence listing

Singh J, Yadav MK, Marahatta SB, Shrestha BL. Indian J Anaesth 2012; 56(4): 348-52

Prospective, crossover, randomised trial of i-gel® against cLMA on 48 post-burn neck contracture patients with reduced neck movement and mouth opening. Primary outcome was overall success rate, with other measurements taken in time to ventilation, leak pressure, fibreoptic view and visualisation of square wave pattern. Success rate for i-gel® was 91.7%, against 79.2% for cLMA. i-gel® outperformed cLMA in all measurements. Authors conclude their study has ‘better clinical performance in the difficult airway management of the airway in the post burn contracture of the neck’.

Link to abstract.

Gupta Richa, Gupta Ruchi, Wadhawan S, Bhadoria P. J Anaesth Clin Pharmacol 2012; 28(3): 397–398

Report of i-gel® (size 2.5) used as a conduit for intubation on a nine-year-old girl scheduled for post-burn contracture with limited neck extension. Spontaneous ventilation and depth of anaesthesia were maintained, even after removal of the i-gel®. Authors conclude that fibreoptic ventilation through i-gel® is a ‘highly successful technique’.

Link to abstract.

Castle N, Pillay Y, Spencer N. Anaesthesia 2011; 66(11): 983-8

Six different supraglottic airway devices, including i-gel®, were tested by 58 paramedics for speed and ease of insertion in a manikin, whilst wearing either a standard uniform or chemical, biological, radiation, nuclear-person protective equipment (CBRN-PPE). During the latter test, i-gel® was the fastest of the six to insert with a mean insertion time of 19 seconds. Overall, the wearing of CBRN-PPE has a detrimental effect on insertion time of supraglottic airways.

Link to abstract.

Corso RM, Piraccini E, Agnoletti V, Baccanelli M, Coffa A, Gambale G. Minerva Anaestesiol 2011; 77(8): 852-3

The i-gel® was used in eight patients for tracheostomy. Patients were extubated and the ET tube was replaced with the i-gel®. A percutaneous tracheostomy kit was then advanced to the second tracheal ring and the procedure was performed. Arterial pressure, PaO2/FiO2, minute ventilation and airway pressure were measured before, during and after tracheostomy. There were no significant differences in ventilatory and haemodynamic parameters. Use of the i-gel® was successful in seven of eight patients. The i-gel® provided better views of the glottis compared to the cLMA and ventilation was comparable to the ET tube. Large trials must take place to determine whether a one in eight failure rate remains.

Abstract text

Sanuki T, Uda R, Sugioka S, Daigo E, Son H, Akatsuka M, Kotani J. Eur J Anaesthesiol. 2011 Aug;28(8):597-9

20 adult patients scheduled for oral surgery were ventilated using the i-gel®. Leak pressure, ventilation score and fibreoptic view were measured with the patient’s head and neck in neutral position, extended position, flexion and rotated to the right. Leak pressure was higher during flexion, lower during extension and comparable to neutral position during rotation. Ventilation score was significantly worse during flexion. Fibreoptic view was not affected by head and neck position. The authors recommend that the i-gel® is not used in cases where head and neck flexion is likely, but they state that it is otherwise suitable for surgery where the head is moved.

Link to abstract.