i-gel® from Intersurgical: clinical evidence listing

Taxak S, Gopinath A. Anaesthesiology 2010; 112(2): 500-501

This correspondence article responds to Theiler et al’s comments on the design of the i-gel® and subsequent effects of tongue size. The authors state that they have noticed a similar issue where the patient’s tongue is carried towards the back of the mouth by the i-gel®, which then cannot be inserted fully. The i-gel® had to be removed and re-inserted. The authors recommend stabilising the tongue before attempting to insert the device. A reply from the authors of the original report says that a tongue retractor should be used for this rather than fingers. This response also points out that although the tongue may also get caught between the teeth and the i-gel® bite block, this could happen with any supraglottic airway.

Link to abstract.

Chapman D. Anaesthesia 2010; 65(1): 89

This letter is a response to the 2009 study by Janakiraman (see page 7) et al. which compared the i-gel® to the LMA Classic®. In that study, the authors stated that the devices were lubricated along the tip and the posterior surface. However, the correct lubrication procedure for the i-gel® is different; the thermoplastic material used to make the device is tacky until lubricated and requires lubrication on all four sides of the cuff.

Abstract text

Kushakovsky V, Ahmad I. Anaesthesia 2009; 64(11): 1262

This letter is a response to a small LMA Supreme® study. The authors say that they have been using the device in patients having nasopharyngeal surgery as it protects the airway from any bleeding and has a gastric channel to remove any blood in the stomach. However, they have reviewed recent research and believe that their current practice may change. In previous studies, the i-gel® has performed as well as the LMA Supreme® even when all i-gel® patients have been given a size 4 device and the LMA Supreme® has been sized correctly. Gastric tube placement in the two devices and the LMA Proseal® is also comparable. The authors are considering the use of the i-gel® or ProSealTM instead of the SupremeTM.

Link to abstract.

Ghai A, Saini S, Hooda S. Anaesthesia 2009; 64(10): 1151

This letter is a response to Baxter’s 2008 report of lightened anaesthesia due to a leak from the gastric channel of the i-gel®. The authors found that they experienced similar problems with the LMA Supreme®. No glottic structures were visualised on fibreoscopy through the airway channel, and through the gastric channel, it revealed the tip in front of the glottis rather than the oesophagus.

Link to abstract.

Drolet P. Can J Anesth 2009; 56(10): 715-720

This article discusses the gastric channel or drain tube as a safety feature provided in supraglottic airways. Although pulmonary aspiration of gastric contents is a relatively rare event, it can be made rarer with the use of devices that include a gastric channel, particularly if they are inserted using a bougie. i-gel® is discussed.

Link to abstract.