i-gel® from Intersurgical: clinical evidence listing

Baxter, S. Anaesthesia 2008; 63(11): 1265

This correspondence article reports a problem that occurred in two patients ventilated with an i-gel® during anaesthesia. In the first case, anaesthesia started to lighten and end-tidal sevoflurane fell. The user suspected air entrainment through the suction port. In the second case, anaesthesia remained stable but end-tidal sevoflurane still dropped. The user placed a finger over the suction port and sevoflurane levels returned to normal. In both cases, the i-gel® was replaced with a laryngeal mask airway.

Link to abstract.

Bamgbade OA, Macnab WR, Khalaf WM. Eur J Anaesthesiol 2008; 25(10): 865-6
This letter reported that first time insertion with i-gel® was achieved in <5 seconds in 290/300 patients. Three patients with difficult airway underwent successful fibreoptic endotracheal intubation through i-gel® and all patients underwent adequate pressure mode ventilation with airway pressures of 10-30cm H2O initially and spontaneous breathing subsequently. In addition, lubricated gastric tubes were easily inserted through the gastric channel at the first attempt in all 80 cases where this was performed. The authors concluded that ‘i-gel® is very suitable for peri-operative airway management, positive pressure ventilation and weaning from ventilation. It is also useful as an intubation aid and has a potential role in airway management during resuscitation. It is very easy to use, highly reliable and associated with minimal morbidity. The gastric channel separates the oesophagus from the larynx and provides protection from aspiration. Further studies are required to compare i-gel® with other supraglottic devices.’

Abstract text

Mustafaeva MN, Mizikov VM, Kochneva ZV, Vashchinskaia TV, Sarkisova NG, Rusakov MA, Levitskaia NN. Anesteziol Reanimatol 2008; (5): 55-58

This paper describes the development of supraglottic airways and the i-gel® in particular. A review of the available i-gel® literature showed that there are considerable benefits to using the device during general anaesthesia. The experiences of the authors during the use of i-gel® in 34 patients are also described. The authors believe that the i-gel® is suitable for use during anaesthesia and potentially resuscitation. However, more research should be carried out, especially in terms of comparison with other supraglottic airways.

Link to abstract.

Liew G, John B, Ahmed S. Anaesthesia 2008; 63(7): 786

A report on a case of a young male patient undergoing surgery where i-gel® helped with the recognition and management of regurgitation. During this case, gastric contents were noticed to be coming out of the gastric channel. No secretions were evident in the airway channel. As regurgitation continued, surgery was paused and the patient’s airway secured following rapid sequence induction. There was no clinical evidence of aspiration and a post-op chest X-ray revealed clear lung fields. It transpired the patient had consumed a fizzy drink a few hours prior to the operation, something he failed to mention during a pre-operative visit.

Link to abstract.

Thompson J, O’Neill S. Br J Hosp Med 2008; 69(5): 303

This review article compares supraglottic airways to tracheal intubation for laparoscopic surgery. Evidence gathered so far indicates that supraglottic airways such as the i-gel® produce adequate ventilation and pressures with a reduced risk of complications such as aspiration. The authors state that further investigation should take place to determine whether these devices can be used in obese patients during laparoscopic procedures.

Link to abstract.