i-gel® from Intersurgical: clinical evidence listing

Kohli M, Wadhawan S, Bhadoria P, Ratan SK. J Anaesthesiol Clin Pharmacol. 2019 Jan-Mar;35(1):30-35

This study aimed to determine the efficacy of the i-gel as compared to the ETT in terms of adequacy of ventilation in 80 children (2-8 years of age) undergoing paediatric laparoscopic surgeries. Several parameters were evaluated including peak airway pressure, end-tidal CO2, minute ventilation, SpO2, as well as desufflation of the peritoneal cavity. These variables were recorded after securing the airway, after carboperitoneum (CP) and after desufflation of the peritoneal cavity. Results showed a significant increase in the partial pressure of mean expired CO2 (PeCo2), peak airway pressure, as well as minute ventilation in both groups after creation of CP. On the other hand, no difference was observed in heart rate or mean arterial pressure. Moreover, the i-gel showed a smaller increase in peak airway pressure and fewer post-operative complications. Thus, both devices were comparable in terms of adequacy of ventilation, but the i-gel was able to provide a safe alternative to the ETT.

Link to abstract.

Amer GF, Abdeldayem OT, Lahloub FMF. Anesth Essays Res 2019 Apr-Jun; 13(2): 209-213

This investigation assessed the use of the i-gel as an alternative to local anaesthesia (LA) in insulin dependents diabetic patients undergoing cataract surgery. 60 diabetic patients were randomly assigned to receive either LA or general anaesthesia (n = 30) in combination with the i-gel (n = 30). Several parameters were monitored including mean arterial blood pressure (MBP), heart rate (HR), as well as blood glucose levels and plasma cortisol levels. Results have shown no significant difference in either blood glucose or cortisol levels in both groups. However, blood glucose level increased in both groups after induction of anaesthesia. In addition, HR and MBP increased in the LA group but not in the i-gel group. In conclusion, these results show that both LA and general anaesthesia using the i-gel are safe and do not produce a marked impact in hemodynamics, blood glucose, or cortisol levels in diabetic patients.

Link to abstract.

Choudhary N, Kumar A, Kohli A, Wadhawan S, Bhadoria P. Indian J Anaesth. 2019 Mar;63(3):218-224

This investigation aimed to compare the successful intubation rate of the i-gel using three types of endotracheal tubes (ETTs). 75 ASA I and II patients (age 18-60 years) undergoing elective surgery under general anaesthesia were randomly assigned into three groups based on the type of endotracheal ETT, which included polyvinyl chloride ETT (Group P), intubating laryngeal mask airway ETT (Group I) and flexometallic ETT (Group F). Recorded parameters included time taken for successful intubation, success rate, number of attemps, manoeuvres, and complications. Results demonstrated that Group P had the lowest time and mean time for intubation, as well as the highest first attempt and overall intubation success rate. Therefore, the combination of polyvinyl chloride ETT with i-gel to intubate patients with difficult airways represents the most successful approach compared to other combinations. However, additional studies are needed to validate these results.

Link to abstract.

Prabha R, Raman R, Parvez Khan M, Kaushal D, Siddiqui A, and
Abbas H. Saudi J Anaesth. 2018 Oct-Dec; 12(4): 535–539

This prospective controlled study aimed to examine the clinical performance of the i-gel in both obese and non-obese patients. 32 patients were divided into two groups, group O (BMI >30 kg/m2) and group C (BMI between 18.5 and 29.9 kg/m2). A range of parameters were evaluated including OLP (primary outcome), leak fraction, time taken to insert the device, ease of insertion, fiberoptic glottis view and adverse events. Results have demonstrated that OLP was marginally higher in Group O in comparison to group C (but not statistically different). In regards to the other parameters and side effects, these were comparable in both groups. Therefore, the i-gel provides an effective tool for the airway management of both obese and non-obese patients.

Link to abstract

Ahn E, Choi G, Kang H, Baek C, Jung Y, Woo Y, Bang S. PLoS One. 2018 Nov 5;13(11):e0206804

This network meta-analysis (with a mixed-treatment comparison method to combine direct and indirect comparisons) compared the effectiveness of seven different SADs as a strategy for unassisted tracheal intubation. The primary outcome was the overall success rate of intubation by intention to treat (ITT) and the secondary outcomes included the overall tracheal intubation success rate (per protocol - PP) and the success rate of tracheal intubation at first attempt by ITT and PP.

Link to abstract.