i-gel

Estudios Clínicos

A comparison of postoperative sore throat and neck complaints after the use of the i-gel and the La Premiere® laryngeal mask: A double-blinded, randomized, controlled trial
Keijzer C, Buitelaar DR, Efthymiou KM, Sramek M, Cate JT, Ronday M, Stoppa T, Huitink JM, Schutte PF. Anesth Analg. 2009 Jul 29.
This study from the department of Anesthesiology and Intensive Care at the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital and the VU University Medical Center in Amsterdam compared the rate of postoperative sore throat and neck complaints with i-gel to a well known brand of laryngeal mask. Patients were interviewed postoperatively as 1hr, 24hrs and 48 hrs. The authors found significantly lower levels of sore throat with i-gel, as well as lower levels of dysphagia.
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Crossover comparison of the Laryngeal Mask Supreme and the i-gel in simulated difficult airway scenario in anesthetized patients
Theiler LG, Kleine-Brueggeney M, Kaiser D, Urwyler MD, Luyet C, Vogt A, Greig R, Unibe MME. Anesthesiology 2009; 111:55-62
This study looked at a simulated difficult airway scenario by using a neck collar to limit both mouth opening and neck movement. Both devices were placed in random order in each of 60 patient. The primary outcome was overall success rate. Other measurements included time to successful ventilation, seal pressure, fibreoptic view and adverse events.The authors concluded the two devices tested had a 'similar insertion success and clinical performance in the simulated difficult airway situation'. The i-gel enabled better fibreoptic laryngeal view and less epiglottic downfolding.
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Is i-gel a new revolution among supraglottic airway devices? - a comparative evaluation
Jindal P, Rizvi A, Sharma JP. Middel East J Anesthesiol. 2009 Feb; 20(1):53-8
This study compared i-gel to two other supraglottic airways in respect of hemodynamic changes, including heart rate, systolic and diastolic blood pressure, mean arterial pressure and rate pressure product. The authors concluded that 'i-gel effectively conforms to the perilaryngeal anatomy despite the lack of an inflatable cuff, it consistently achieves proper positioning for supraglottic ventilation and causes less hemodynamic changes as compared to other supraglottic airway devices.
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Influence of airway management strategy on 'no-flow-time' in a standardized single rescuer manikin scenario - a comparison between LTS-D and i-gel
Wiese CHR, Bahr J, Popov AF, Hinz JM, Graf BM. Resuscitation 80 (2009) 100-103.
This paper, compared i-gel to another supraglottic airway in a manikin cardiac arrest scenario. The study evaluated the effect use of these devices had on No-flow time (NFT). The authors stated that 'an ideal supraglottic airway should be inserted rapidly with minimal training and it should enable controlled ventilation'. i-gel met those criteria during resuscitation in a manikin and NFT was kept as low as possible, consistent with ERC guidelines.
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The i-gel, a single-use supraglottic airway device with a non-inflatable cuff and an esophageal vent: An observational study in children
Beylacq L, Bordes M, Semjen F, Cros AM. Acta Anaesthesiol Scand 2009; 53: 376-379
This study evaluated i-gel in 50 children above 30kg undergoing short-duration surgery. The parameters measured included; ease of insertion, seal pressure, ease of inserting a gastric tube and post operative complications. The first time insertion success rate was 100%. No laryngeal leak occurred. The mean seal pressure was 24.9cm H20. The authors concluded that i-gel was very easy to insert and that 'no learning curve is needed before a high success insertion rate is obtained. The i-gel appears to be safe for paediatric management'
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Effect of chest compressions on the time taken to insert airway devices in a manikin
Gatward JJ, Thomas MJC, Nolan JP, Cook TM. Br J Anaesth. 2008 Mar;100(3):351-6
In this study, forty volunteer doctors regularly involved in CPR, were timed inserting four different airway devices, including i-gel and a tracheal tube, with and without stopping chest compressions. Comparison of the speed of insertion of the different devices during CPR allowed ranking of the devices. The i-gel was inserted approximately 50% faster than the other devices tested.
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Oesophageal seal of the novel supralaryngeal airway device i-gel in comparison with the laryngeal mask airways Classic and ProSeal using a cadaver model
Schmidbauer, Bercker S, Volk T, Bogusch, Mager G, Kerner T. Br J Anaesth. 2009 Jan;102(1):135-9
The three supraglottic devices were inserted into eight unfixed cadaver models with exposed oesophagi, connected to a water column producing both a slow and fast oesophageal pressure increase. During a fast increase of oesophageal pressure (simulated vomiting procedure) with the oesophageal lumen of the i-gel and pLMA open, the authors reported that 'the entire oesophageal liquid was drained to the outside without any tracheal aspiration occurring.'
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A new single use supraglottic airway with a noninflatable cuff and an esophageal vent: An observational study of the i-gel
Richez, Saltel L, Banchereau, Torrielli R, Cros AM. Anesth Analg. 2008 Apr;106(4):1137-9
This study on 71 ASA I-II women scheduled for gynaecological surgery, reported a 97% insertion success rate with i-gel. mean seal pressure was 30cm H2O. A gastric tube was inserted in 100% of cases. Only one case of courghing and sore throat occurred. The authors concluded that 'The i-gel is a reliable, easily inserted airway device that provides an adequate seal with a low morbidity rate.'
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Extraglottic airway devices for use in diving medicine - part 3: the i-gel
Acott CJ. Diving and Hyperbaric Medicine. Vol 38. No 3. Oct 2008
This study looked at the use of i-gel in airway management of a patient in a diving bell or deck decompression chamber. The study highlighted the potential limitations of some supraglottic airways used in Hyperbaric Medicine, such as possible cuff expansion with a decrease in pressure on decompression and change in cuff volume due to gas diffusion as the gas mixtures breathed change, problems not associated with i-gel. It showed that, subjectively, there was no change in the consistency of the i-gel at 203 and 283kPa pressure and that no bubbles were detected following decompression from 203, 283 or 608kPa. The i-gel was also preferred by the Diver Medical Technician’s (DMT’s) to the alternative device included in the manikin section of the study because it ‘lacked a cuff and was easier to insert from any position’.
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i-gel insertion by novices in manikins and patients
Wharton NM, Gibbison B, Gabbott DA, Haslam GM, Muchatuta N, Cook TM. Anaesthesia. 2008 Sep;63(9):991-5
This study evaluated the performance of i-gel in manikins and anaesthetised patients when used by novices. The i-gel was deployed with minimal evidence of patient trauma and 100% insertion success. In their summary, the authors concluded that ‘i-gel is rapidly inserted in both manikins and patients by novice users and compares favourably to other supraglottic airways available. Further work determining safety and efficacy during cardio-pulmonary resuscitation is required.'
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Comparison of the i-gel with the cuffed tracheal tube during pressure-controlled ventilation
Uppal V, Fletcher G, Kinsella J. BJA 102(2): 264-8 (2009)
In this study, published in the BJA, twenty-five patients were given a standard anaesthetic, followed by insertion of an i-gel. The lungs were ventilated at three different pressures and the difference between the inspired and expired tidal volumes used to calculate the leak volume and leak fraction. The i-gel was then removed and replaced with a conventional tracheal tube, for which similar readings were taken. The results were then compared. From the data taken, the authors concluded that, ‘compared with a tracheal tube there is no significant difference in the gas leak when using an i-gel during PCV with moderate airway pressures’.
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Comparison of clinical performance of i-gel with LMA-ProSeal in Elective surgeries
Singh I, Gupta M, Tandon M. Indian Journal of Anaesthesia 2009; 53(3): 302-305
This clinical investigation into performance of i-gel compared to another supraglottic airway with gastric access, concluded that i-gel was easier to insert, required less attempts at insertion, had easier gastric tube placement and was less traumatic than the other device tested. Sixty patients were randomly assigned into two groups Group 1 (n=30) for i-gel and Group P (n=30). Assessment was made of sealing pressure, ease of insertion, success rate of insertion, ease of gastric tube placement, airway trauma by post operative blood staining of the device, tongue, lip and dental trauma, hoarseness, regurgitation/aspiration and cost effectiveness.
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Evaluation of the size 4 i-gel airway in one hundred non-paralysed patients
Gatward JJ, Cook TM, Seller C, Handel J, Simpson T, Vanek V, Kelly F. Anaesthesia 2008. Oct;63(10):1124-30
A study of i-gel in 100 elective, anaesthetied patients. Parameters assessed included, ease of use, positioning, airway quality, seal pressure and complications. First time insertion success was 86%. Median airway leak pressure was 24cm H2O. On fibreoptic examination via the device, the vocal cords were visible in 91% of patients. The incidence of airway obstruction, airway irritation, oropharyngeal trauma and other complications was low. Insertion of the device into the correct position was rapid and easy. The authors concluded that 'These attributes would suggest potential roles in anaesthesia, management of the difficult airway and airway management during CPR'. Further studies are now indicated against i-gel's likely clinical competitors.
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Initial anatomic investigations of the i-gel airway: a novel supraglottic airway without inflatable cuff
Levitan RM, Kinkle WC. Anaesthesia, 2005, 60, pages 1022-1-26
A study of the positioning and mechanics of the i-gel in 65 non-embalmed cadavers, with 73 endoscopies, 16 neck dissections and 6 neck radiographs. The mean percentage of glottic opening score for the 73 insertions was 82%. In each of the neck dissections and radiographs the bowl of the device covered the laryngeal inlet. In their summary, the authors concluded that the i-gel was consistently positioned over the laryngeal inlet and that the unique gel-like material of the device performed as intended, conforming to the perilaryngeal anatomy.
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Informes de casos

i-gel supraglottic airway for rescue airway management and as a conduit for intubation in a patient with acute respiratory failure
Campbell J, Michalek P, Deighan M. Resuscitation. 2009 Aug;80(8):963
This case report details the case of a 54 year old man with acute respiratory failure, who had a grade 4 view at laryngoscopy. He was difficult to bag-mask ventilate and a laryngeal mask was inserted as an airway rescue technique. As ventilation was not possible with this device, it was removed and a size 4 i-gel inserted. This allowed good ventilation. A fibrescope was passed down the airway channel and a 7.0mm endotracheal tube passed over the fibrescope and through the i-gel. The i-gel was then removed, leaving the airway secure.
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Successful use of the i-gel airway in prone position surgery
Senthil Kumar M, Pandey R, Khanna P. Paediatr Anaesth. 2009 Feb; 19(2): 176-7.
This case report, published in 'Pediatric Anesthesia', highlighted the case of a 10 year old child, weighing 30kg, scheduled for an elective pyeloplasty. A size 3 i-gel was inserted and secured after confirming correct placement and a suction catheter inserted down the gastric channel. The child was positioned prone and the correct positioning of i-gel reconfirmed by appropriate CO2 wave form, absence of audible leak and chest auscultation. At the end of the procedure, the child was returned to a supine position and i-gel removed after reversal. The patient recovered without any complications.
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Fibreoptic intubation through an i-gel supraglottic airway in two patients with predicted difficult airway and intellectual disability
Michalek P, Hodgkinson P, Donaldson W. Anesth Analg. 2008 May;106(5):1501-4
This case study describes successful fibre-optic guided tracheal intubation through the i-gel in two uncooperative adult patients with learning disability and predicted difficult airway. The i-gel maintained the airway immediately after induction, allowing oxygenation and ventilation. Fibreoptic identification of the laryngeal inlet was successful on the first attempt and a tracheal tube inserted into the trachea, without complication, in both patients.
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Use of an i-gel for airway rescue
Joshi NA, Baird M, Cook TM. Anaesthesia, 2008 63, pages 1010-1026
This case report concerns a middle-aged female patient scheduled for an elective operation on the hand. She had undergone several general anesthetics in the past when a cLMA had been used without documented problems. She had a Mallampatis score of three and a thyromental distance of 6cm. Face mask ventialtion with an oropharyngeal airway was extremely difficult. A pLMA was inserted, but ventilation was not possible. A size 4 cLMA was also tried with the same result. A size 4 i-gel was then inserted. This immediately provided unobstructed ventilation and stable oxygenation saturation of 98%. The authors commented that 'The i-gel's role in difficult airway management remains to be established, but its ease of insertion, short wide airway tube and good airway leak pressures make it a potentially useful airway device in cases of difficult mask ventilation.'
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The i-gel supraglottic airway and resuscitation - some initial thoughts
Soar J. Resuscitation. 2007 Jul;74(1):197
This case report detailed use of a size 4 i-gel during a cardiac arrest. The i-gel was inserted in <10 seconds from opening the packet. The author was able to ventilate the patients lungs easily using a self-inflating bag-valve device connected to the i-gel. The patients lungs were ventilated asynchronously during chest compressions with no leak. There was no evidence of aspiration. In addition, this case report confirmed the training of five non-anaesthetic trainee doctors to insert the i-gel and ventilate an anaesthetised patient after minimal instruction. All these trainees rated i-gel easier to insert than a laryngeal mask airway.
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Aspiration recognition with an i-gel airway
Liew G, John B, Ahmed S. Anaesthesia. 2008 Jul;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 and the patients airway secured following rapid sequence induction. ‘Laryngoscopy revealed a clear view of the trachea (Cormack & Lehane grade 1) with no evidence of gastric contents’. The patient remained stable throughout the remainder of the operation. 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 can of Coca-Cola a few hours prior to the operation, something he failed to mention during a pre-operative visit.
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The i-gel airway for ventilation and rescue ventilation
Sharma S, Rogers R, Popat M. Anaesthesia, 2007, 62, pages 412-423
This case report concerns use of an i-gel on a teenage patient scheduled for closure of colostomy. Two year previously he had a grade 3 (Cormack & Lehane) view at laryngoscopy. On this occasion there were no clinical features to predict difficult intubation. laryngoscopy revealed a grade 4 view. Two attempts at tracheal intubation with a gum elastic bougie failed. A cLMA was inserted. Despite providing satisfactory ventilation, two attempts at fibreoptic intubation through the device failed. A size 4 i-gel was inserted and satisfactory ventilation achieved. After fibreoptic confirmation of a good view of the vocal cords, a size 6.5mm cuffed tracheal tube was successfully passed through the i-gel blindly into the trachea at the first attempt. he i-gel was left in place until extubation.
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