i-gel® from Intersurgical: clinical evidence listing

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

The influence of head and neck position on ventilation with the i-gel® airway in paralysed, anaesthetised patients

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.

 

Successful use of i-gel in three patients with difficult intubation and difficult ventilation

Asai T. Masui. 2011; 60(7): 850-2

Three cases of successful ventilation using the size three i-gel® on female patients with a mix of predicted and unpredicted difficult intubation, and where both facemask ventilation and tracheal intubation were difficult. Author concludes that i-gel ‘has a potential role as a rescue device, by allowing ventilation and tracheal intubation in patients with difficult airways.’

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The i-gel® in failed obstetric tracheal intubation

Berger M, Corso RM, Piraccini E, Agnoletti VA, Valtancoli E, Gambale G. Anaesth Intensive Care 2011; 39(1): 136

A 36-year-old morbidly obese pregnant woman presented for emergency caesarian was anaesthetised using RSI. To limit insertion attempts an i-gel® was used, successfully inserted at the first attempt and a healthy baby was delivered with no further complication to the mother. Concluded that i-gel® is likely to be the better airway management device when speed is of the essence, compared to other laryngeal masks.

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Use of an i-gel® in a ‘can’t intubate/can’t ventilate’ situation

Corso RM, Piraccini E, Agnoletti V, Gambale G. Anaesth Intensive Care 2010; 38(1): 211

This report details the use of an i-gel® to provide an airway for a 63-year-old male with severe subglottic swelling. Two prior attempts at insertion of a gum elastic bougie failed and facemask ventilation was ineffective. A well-known brand of laryngeal mask was inserted, but ventilation was impossible, so it was removed and replaced with an i-gel®. Subsequent intubation through the i-gel® was performed successfully with a flexible fibrescope.

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Airway management using i-gel® in two patients for awake craniotomy

Tsuruta S, Yamada M, Shimizu T, Satsumae T, Tanaka M, Mizutani T. Masui 2010; 59 (11): 1411-1414

This paper describes the use of an i-gel® for ventilation during two craniotomy procedures. Both patients were anaesthetised and operated on using the asleep-awake-asleep technique. The i-gel® was inserted successfully and removed for the first time as the patients were able to respond to their own names being called. After the ‘awake’ period of surgery was complete, the i-gel® was reinserted easily in both cases despite a 30° rotation of the neck. There were no adverse incidents. The authors conclude that the i-gel® is appropriate for use during asleep-awake-asleep surgery due to the ease of insertion when the neck is rotated.

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